| 金德奎 於四军 王文启 吴雨径 刘惠亮.早期心电图QRS 波宽度对急性ST 段抬高型心肌梗死患者心脏不良事件的影响[J].,2016,16(15):2949-2952 |
| 早期心电图QRS 波宽度对急性ST 段抬高型心肌梗死患者心脏不良事件的影响 |
| Effects of Early Electrocardiographic QRS Width on Recent Major AdverseCardiac Events in Patient with Acute ST-segment Elevation MyocardialInfarction |
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| DOI： |
| 中文关键词: ST 段抬高型心肌梗死 QRS波宽度 主要心脏不良事件 危险因素 |
| 英文关键词: ST-segment elevation myocardial infarction QRS width Major adverse cardiac event Risk factor |
| 基金项目:卫生部医药卫生科技发展项目（W2013GJ09） |
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| 中文摘要: |
| 目的：探讨早期心电图QRS 波宽度(QRSw)对急性ST 段抬高型心肌梗死(STEMI)患者近期主要心脏不良事件(MACE)的影
响。方法：选取我院收治的135 例STEMI患者为研究对象，按照入院时的心电图QRSw将患者分为A 组(QRSw 为60 ms≤ QRSw≤
80 ms)、B 组(QRSw 为80 ms＜QRSw＜100 ms)、C 组(QRSw 为QRSw≥ 100 ms)，将是否发生MACE分为MACE组和非
MACE 组，比较各组相关指标的差异，分析QRSw 与MACE发生的关系。结果：A、B 及C 组三组患者在梗死面积、肌酸激酶同工
酶(CK-MB)、肌钙蛋白I(cTnI)、B 型脑钠肽(BNP)、高敏C 反应蛋白(hs-CRP)、左室射血分数(LVEF)方面存在显著的统计学差异
(P＜0.05)，与A组及B组比较，C组血清hs-CRP、BNP、cTnI、CK-MB 较高，梗死面积大、LVEF 偏低。三组患者在MACE 发生率
方面亦存在显著的统计学差异(P＜0.05)，C 组高于A 组及B 组。MACE 组患者QRSw 高于非MACE 组(P＜0.05)，其含有QRSw≥
100 ms患者的比例亦高于非MACE 组(P＜0.05)；QRSw(OR=1.214，CI:1.104～1.441，P＜0.05)是STEMI患者近期MACE 发
生的独立危险因素。结论：STEMI患者随着QRSw 增大，MACE 的发生风险亦增加，QRSw 可能是STEMI患者近期MACE 发生
的独立危险因素，应当引起临床重视。 |
| 英文摘要: |
| Objective:To explore the effects of early electrocardiographic QRS width (QRSw) on recent major adverse cardiac
events (MACE) in patient with acute ST-segment elevation myocardial infarction(STEMI).Methods:A total of 135 cases of STEMI patients
in our hospital fromJune 2014 to June 2015 were selected as the research subjects. All patients were divided into group A (QRSw:
60ms≤ QRSw≤ 80 ms), groupB (QRSw: 80 ms＜QRSw＜100 ms), groupC (QRSw: QRSw≥ 100 ms) according to QRSw on admission.
Meanwhile, all patients were divided into MACE group and non-MACE group according to MACE in hospitalization. Related indexes
were compared between the groups, and multivariable logistic regression model was used to analyze the relationship of QRSw with
MACE.Results:There were statistically significant differences in infarction area, CK-MB, cTnI, BNP, hs-CRP and LVEF between group
A, B and C (P<0.05). The CK-MB, cTnI, BNP, hs-CRP levels were higher in group C than in group A and B, and the infarction area was
larger, and LVEF was lower in group C. There were also statistically significant differences in incidence of MACE between three groups
(P<0.05). The incidence of group C was higher than those of group A and B. QRSw of MACE group was longer than that of non MACE
group (P<0.05), and the proportion of patients with QRSw≥ 100ms in MACE group was higher than that of non MACE group (P<0.05).
Multivariable logistic regression analysis showed that QRSw (OR=1.214, CI: 1.104~1.441, P<0.05) was independent risk factor of
MACE.Conclusion:The risk of MACE increased with the increasing of QRSw. QRSw may be an independent risk factor for recently occurred
MACE in STEMI patients, and should be pay more clinical attentions. |
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