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目的分析老年急性心肌梗死(AMI)患者心电图QRS时限与AMI预后的关系。方法选择2010年10月—2012年12月心内科收治的老年AMI患者180例,QRS时限>110 ms为延长组,≤110 ms则为正常组,各90例,分别检查患者的N-末端脑钠肽前体浓度、LVEF、心功能Killip分级以及主要不良心血管事件发生率等指标并进行比较。结果延长组患者的N-末端脑钠肽前体浓度为300～15 000 nmol/L,高于正常组的70～7400 nmol/L,且取其对数值进行比较,延长组亦高于正常组(P<0.01),而LVEF值低于正常组(P<0.01);2组患者心功能Killip分级存在显著差异(P<0.01),延长组恶性心律失常、急性肺水肿、心源性休克发生率及病死率均高于正常组(P<0.05,P<0.01)。结论 QRS时限延长的AMI患者发生不良心血管事件的几率大于QRS时限正常患者,QRS时限在对老年AMI患者进行预后评估时有重要的临床意义。
Objective To analyze the relation between ECG QRS duration and AMI prognosis in elderly patients with acute myocardial infarction (AMI). Methods 180 elderly patients with AMI who were admitted to Department of Cardiology from October 2010 to December 2012 were enrolled. The QRS duration was> 110 ms for the extended group and ≤110 ms for the normal group. All patients were examined for N-terminal brain Natriuretic peptide concentration, LVEF, Killip classification of cardiac function and the incidence of major adverse cardiovascular events and other indicators and compared. Results The concentration of N-terminal pro brain natriuretic peptide in the extended group was 300-15 000 nmol / L, which was higher than that in the normal group (70-7400 nmol / L), and compared with the normal group (P <0.01), while the LVEF was lower than that of the normal group (P <0.01). There was significant difference in Killip grading between the two groups (P <0.01). Malignant arrhythmia, acute pulmonary edema and cardiogenic shock occurred in the prolonged group Rate and mortality were higher than the normal group (P <0.05, P <0.01). Conclusions The incidence of adverse cardiovascular events in AMI patients with prolonged QRS duration is greater than that in patients with normal QRS duration. The QRS duration is of great clinical significance in the prognosis assessment of elderly AMI patients.