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目的:观察冠状动脉慢性完全闭塞病变(CTO)患者接受经皮冠状动脉介入(PCI)术后心功能的改善情况以及合并碎裂QRS波的关系。方法:通过回顾性分析2010-01-2014-10成功行PCI治疗的260例CTO患者,根据入院时12导联心电图的QRS波形态分为碎裂QRS波组(fQRS组,76例)和无碎裂QRS波组(nfQRS组,184例),随访分析两组患者PCI术后6个月心功能的改善情况是否存在差异。结果:两组患者PCI术后左室射血分数(LVEF)增加,左室舒张末容积指数(LVEDVI)减少,NYHA心功能分级明显改善,但和fQRS波相比,nfQRS波组的患者LVEF[(42.1±3.51)%∶(53.26±4.47)%,P<0.05]增加更显著,LVEDVI[(85.3±8.29)ml/m~2∶(76.14±8.05)ml/m~2,P<0.05]减少更明显,NYHA心功能分级亦有明显改善(P<0.05)。结论:血运重建治疗能够改善CTO患者的心功能,不合并fQRS波的患者较合并fQRS患者改善更显著。
Objective: To observe the improvement of cardiac function after percutaneous coronary intervention (PCI) in patients with chronic total occlusion of coronary artery (CTO) and the relationship between QRS wave and fragmentation. Methods: 260 patients with CTO who underwent PCI during 2010-01-2014-10 were retrospectively analyzed. According to the 12-lead electrocardiogram (QRS) morphology at admission, they were divided into fragmented QRS wave group (fQRS group, 76 cases) and no Fragmentation QRS wave group (nfQRS group, 184 cases), follow-up analysis of two groups of patients 6 months after PCI heart function improvement is there any difference. Results: Left ventricular ejection fraction (LVEF) increased, left ventricular end-diastolic volume index (LVEDVI) decreased and NYHA functional class improved significantly after PCI in both groups. Compared with fQRS wave, LVEF [ (42.1 ± 3.51)% vs (53.26 ± 4.47)%, P <0.05]. The LVEDVI was significantly higher in patients with LVEDVI (85.3 ± 8.29 ml / m 2 vs 76.14 ± 8.05 ml / m 2, P 0.05) Decreased more significantly, NYHA cardiac function also significantly improved (P <0.05). CONCLUSIONS: Revascularization can improve cardiac function in patients with CTO, and patients with fQRS do not improve more significantly than patients with fQRS.