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目的:探讨静息12导联心电图的碎裂QRS波(f QRS)对于ST段抬高型急性心肌梗死(STEMI)患者1年期预后的预测价值。方法:选择STEMI患者154例,分为无f QRS、f QRS两组,随访观察1年。分别比较了各组的基本资料、危险因素及造影情况、左室射血分数(LVEF)、室壁运动异常发生率,恶性心律失常发生率和全因病死率。结果:1两组患者基本资料及3种主要心血管危险因素未见显著差异,f QRS组较无f QRS组肌钙蛋白I(Tn I)值高,3支病变比例大;2f QRS组患者较无f QRS组患者住院期间病死率高、LVEF<50%比例高;3f QRS组1年期随访病死率、恶性心律失常发生率、LVEF%<50%比例均显著高于无f QRS组,LVEF%值较低。4同组患者住院期间与1年随访比较,无f QRS组病死率和LVEF<50%比例未见显著差异;室速发生率和室壁运动异常发生率有所减少,LVEF改善。f QRS组病死率增加,其他观察指标均未见明显统计学差异。结论:12导联心电图f QRS对于STEMI患者的预后具有一定预测价值。
Objective: To investigate the predictive value of QRS complex (f QRS) of resting 12-lead electrocardiogram in predicting the one-year prognosis of patients with ST-segment elevation acute myocardial infarction (STEMI). Methods: One hundred and five patients with STEMI were selected and divided into two groups without f QRS and f QRS. The patients were followed up for 1 year. The basic data, risk factors and angiography, left ventricular ejection fraction (LVEF), abnormalities of ventricular wall motion, incidence of malignant arrhythmia and all-cause mortality were compared among the groups. Results: There was no significant difference between the two groups in the basic data and the three major cardiovascular risk factors. The f QRS group had a higher Tn I value and a larger proportion of the three lesions. The patients in the 2f QRS group Compared with patients without f QRS, the patients with high fMRI had a higher case fatality rate and higher LVEF <50%. The 1-year follow-up mortality, incidence of malignant arrhythmia and LVEF% <50% in 3f QRS group were significantly higher than those without f QRS group LVEF% value is low. 4 In the same group of patients hospitalized compared with 1-year follow-up, f QRS group mortality and LVEF <50% no significant difference; the incidence of ventricular tachycardia and ventricular wall motion abnormalities decreased, LVEF improved. f QRS group mortality increased, other observations were no significant statistical difference. Conclusion: The 12-lead electrocardiogram f QRS has some predictive value for the prognosis of STEMI patients.