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目的探讨急性非ST段抬高型心肌梗死(non-ST elevated acute myocardial infarction,NSTEMI)患者碎裂QRS波对临床预后的影响。方法经冠状动脉造影确诊NSTEMI患者312例,根据住院期间第一份心电图是否存在碎裂QRS波分为碎裂QRS波组173例和无碎裂QRS波组139例,比较2组一般资料,随访6个月并记录2组主要不良心脏事件(major adverse cardiac events,MACE)发生情况。结果碎裂QRS波组3支以上冠状动脉狭窄≥50%者比率(51.45%)、既往心肌梗死比率(52.51%)高于无碎裂QRS波组(36.69%、30.22%),左室射血分数[(54.00±5.60)%]低于无碎裂QRS波组[(61.00±5.80)%],高敏C反应蛋白水平[8.1(3.2,19.2)mg/L]高于无碎裂QRS波组[6.1(3.2,12.6)mg/L](P<0.05);碎裂QRS波组总MACE发生率(33.53%),再次经皮冠状动脉介入治疗(8.67%)、复发性心绞痛比率(18.45%)均高于对照组(15.83%、2.88%、7.19%)(P<0.05)。结论碎裂QRS波是NSTEMI患者预后不良的重要心电图特征。
Objective To investigate the effect of fragmented QRS wave on clinical prognosis in patients with acute non-ST elevated acute myocardial infarction (NSTEMI). Methods Three hundred and thirteen patients with NSTEMI confirmed by coronary angiography were divided into two groups according to whether there were QRS waves in the first electrocardiogram during hospitalization: 173 cases with fragmented QRS group and 139 cases with no fragmented QRS wave group. The general data of two groups were compared and followed up 6 months and record the occurrence of 2 major adverse cardiac events (MACE). Results The rate of previous myocardial infarction (52.51%) was higher in QRS wave group than in QRS wave group (36.69%, 30.22%), and left ventricular ejection fraction Score of [(54.00 ± 5.60)%] was lower than that of QRS wave without fragmentation [(61.00 ± 5.80)%], high sensitivity C reactive protein (P <0.05). The incidence of MACE in fractured QRS wave group (33.53%), again PCI (8.67%) and recurrent angina pectoris rate (18.45% ) Were higher than the control group (15.83%, 2.88%, 7.19%) (P <0.05). Conclusion Fragmentation QRS wave is an important ECG characteristic of poor prognosis in patients with NSTEMI.