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目的探讨碎裂QRS波在急性冠脉综合征诊断及预后判断中的价值。方法采用分组对照法,比较1 000例急性冠脉综合征病人与1 000名正常对照组人群心电图的碎裂QRS波(fQRS)发生率,分析fQRS与急性冠脉综合征的相关性。随访有fQRS与无fQRS的急性冠脉综合征病人1周、1个月、1年死亡率,分析fQRS对急性冠脉综合征预后的价值。结果急性冠脉综合征病例组与正常对照组fQRS发生率比较,差异有统计学意义(P<0.001);随访急性冠脉综合征病例组病人发病1周、1个月、1年病死率,有fQRS组高于无fQRS组,差异有统计学意义(P值分别为0.002、<0.001、<0.001);急性冠脉综合征有fQRS组与无fQRS组发病1周至1个月增加的病死率差异有统计学意义(P=0.023),但1个月至1年增加的病死率差异无统计学意义(P=0.322)。结论 fQRS发生对急性冠脉综合征的诊断及短期预后有临床意义。
Objective To investigate the value of fragmented QRS wave in the diagnosis and prognosis of acute coronary syndrome. Methods The group comparison method was used to compare the incidence of fragmented QRS wave (fQRS) in electrocardiogram (ECG) of 1 000 ACS patients and 1 000 healthy controls. The correlation between fQRS and acute coronary syndrome was analyzed. The patients with acute coronary syndromes who had fQRS and without fQRS were followed up for 1 week, 1 month and 1 year mortality. The prognostic value of fQRS in patients with acute coronary syndrome was analyzed. Results The incidence of fQRS in patients with acute coronary syndrome was significantly higher than that in healthy controls (P <0.001). The follow-up of 1-week, 1-month and 1-year mortality in patients with acute coronary syndrome FQRS group was higher than without fQRS group, the difference was statistically significant (P values were 0.002, <0.001, <0.001); acute coronary syndrome fQRS group with no fQRS group increased incidence of 1 week to 1 month mortality The difference was statistically significant (P = 0.023), but there was no significant difference in the mortality rate between 1 month and 1 year (P = 0.322). Conclusion The occurrence of fQRS has clinical significance in the diagnosis and short-term prognosis of acute coronary syndrome.