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目的 :探讨分析超声心动图联合心电图QRS碎裂波(f QRS)在心肌梗死诊断价值及其临床效果观察。方法 :选取2014年6月~2016年6月我院收治的128例心肌梗死患者,根据超声心动图联合心电图QRS破碎波检查分为3组,其中A组46例,无f QRS波,左心室射血分数(Left ventricular ejection fractions,LVEF)正常;B组37例,患者伴f QRS波,LVEF正常;C组45例,伴f QRS波,LVEF<50%。比较分析3组患者的冠状造影结果以及室性心律失常的情况。结果 :C组患者的多支病变的发生率为91.11%,显著高于A组的41.30%和B组的78.38%,比较差异具有统计学意义;C组患者的完全性闭塞发生率为48.89%,显著高于A组的8.70%和B组的16.22%,比较差异具有统计学意义。A组患者的Lown分级I级、II级分别为9例(19.57%)、21例(45.65%),B组的Lown分级I级、II级分别为4例(10.81%)、8(21.62%),C组的Lown分级I级、II级分别为0例(0)、2例(4.44%)。C组患者Lown分级III级以上43例(95.56%),显著高于A组的16例(34.78%)和B组的25例(67.57%),比较差异具有统计学意义。结论:伴f QRS波且LVEF下降患者的冠状动脉多支病变、完全性闭塞,以及严重室性心律失常的发生率极高,超声心动图联合f QRS在心肌梗死的诊断中效果显著,具有显著的预警价值。
Objective: To investigate the diagnostic value of echocardiography combined with electrocardiographic QRS fragmentation (f QRS) in myocardial infarction and its clinical effect. Methods: A total of 128 patients with myocardial infarction admitted to our hospital from June 2014 to June 2016 were divided into 3 groups according to echocardiography combined with ECG QRS broken wave examination. Among them, 46 patients in group A had no f QRS wave and left ventricular The left ventricular ejection fraction (LVEF) was normal in group B. In group B, 37 patients had f QRS wave and normal LVEF. In group C, 45 patients had f QRS wave and LVEF was less than 50%. The results of coronary angiography and ventricular arrhythmia were compared among the three groups. Results: The incidence of multivessel disease in group C was 91.11%, which was significantly higher than that in group A (41.30%) and group B (78.38%), the difference was statistically significant. The complete occlusion rate in group C was 48.89% , Which was significantly higher than that of group A (8.70%) and group B (16.22%), the difference was statistically significant. There were 9 cases (19.57%) and 21 cases (45.65%) of Lown grade I and II in group A, 4 cases (10.81%) and 8 (21.62% ), Lown grade I and II in group C were 0 (0) and 2 (4.44%) respectively. There were 43 cases (95.56%) of Lown grade III or above in group C, which were significantly higher than 16 cases (34.78%) in group A and 25 cases (67.57%) in group B, the difference was statistically significant. Conclusions: The incidence of multiple coronary lesions, complete occlusion and severe ventricular arrhythmia in patients with f QRS wave and decreased LVEF is extremely high. Echocardiography combined with f QRS has a significant effect in the diagnosis of myocardial infarction, with significant Early warning value.