[1]李牧蔚),王地)#,高传玉),等.fQRS、Tpec、QTd与急性心肌梗死PCI术后恶性心律失常发生的关系[J].郑州大学学报(医学版),2013,(05):684.
 LI Muwei),WANG Di),GAO Chuanyu),et al.Relationship of fQRS,Tpec,QTd with malignant arrhythmia events in patients undergoing PCI due to acute myocardial infarction[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2013,(05):684.
点击复制

fQRS、Tpec、QTd与急性心肌梗死PCI术后恶性心律失常发生的关系
分享到:

《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2013年05期
页码:
684
栏目:
应用研究
出版日期:
2013-09-02

文章信息/Info

Title:
Relationship of fQRS,Tpec,QTd with malignant arrhythmia events in patients undergoing PCI due to acute myocardial infarction
作者:
李牧蔚1)王地2)#高传玉1)张优1)肖文涛1)
1)河南省人民医院心内科 郑州 4500032)郑州市第七人民医院心内科 郑州 450006
Author(s):
LI Muwei1) WANG Di2)GAO Chuanyu3)ZHANG You3)XIAO Wentao3)
1)Department of Cardiology,Henan Provincial Peoples Hospital, Zhengzhou 4500032)Department of Cardiology, the Seventh Peoples Hospital of Zhengzhou,Zhengzhou 450006
关键词:
心肌梗死fQRSTpecQTd恶性心律失常事件
Keywords:
myocardial infarction fragmented QRS TpecQT dispersion malignant arrhythmia event
分类号:
R541.4
摘要:
目的:探讨急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入(PCI)治疗后碎裂QRS波(fQRS)、校正Tpe间期(Tpec)、QT离散度(QTd)与恶性心律失常事件(MAE)发生的关系。方法:临床确诊的急性STEMI患者96例,12 h内成功施行PCI,随访1个月,发生MAE 24例,未发生MAE(NMAE)72例,分析其心电图指标和血生化指标。以60例正常人的心电图为对照。结果:MAE组fQRS阳性、Tpec≥100 ms、QTd≥70 ms的比例高于NMAE组(χ2=6.192,5.714和6.128,P<0.05)。急性STEMI患者PCI术前Tpec和QTd较对照延长(t=23.947,17.652,P<0.05),术后两者逐渐恢复,但仍高于对照(P<0.05)。术前和术后1周、1个月,MAE组Tpec、QTd均高于NMAE组(F组间=32.675,33.476,P<0.05)。logistic回归分析显示,fQRS阳性(OR=2.805,95%CI=1.008~7.805)、Tpec≥100 ms(OR=3.414,95%CI=1.081~10.776)、QTd≥70 ms(OR=2.979,95%CI=1.058~8.386)是急性STEMI患者PCI术后MAE发生的危险因素。结论: fQRS、Tpec、QTd是急性STEMI患者PCI术后MAE发生的危险因素。
Abstract:
Aim: To explore the relationship of fragmented QRS (fQRS), corrected Tpe interval(Tpec) and QT dispersion (QTd) with occurrence of malignant arrhythmia events(MAE) in acute STsegment elevation myocardial infarction (STEMI) patients underwent successful percutaneous coronary intervention(PCI). Methods:Ninetysix patients with acute STEMI treated successfully with PCI in 12 hours were followed up for one month, and 24 cases developed MAE and 72 cases without MAE(NMAE). ECG indicators and blood biochemical indicators were analyzed. Sixty cases with normal ECG were collected as control. Results: The proportion of positive fQRS, Tpec≥100 ms and QTd≥70 ms in MAE group were higher than those in NMAE group(χ2=6.192,5.714 and 6.128,P<0.05). Compared with the control, Tpec and QTd were prolonged significantly in acute STEMI patients(t=23.947,17.652,P<0.05). After PCI, Tpec and QTd gradually restored but still higher than the control(P<0.05). Tpec and QTd of MAE group were significantly higher than those of NMAE group before operation, 1 week and 1 month after operation(Fgroup=32.675,33.476,P<0.05). Logistic regression analysis showed that positive fQRS (OR=2.805,95%CI=1.008-7.805), Tpec≥100 ms (OR=3.414,95%CI=1.081-10.776), QTd≥70 ms (OR=2.979,95%CI=1.058-8.386) were the risk factors of MAE in patients with acute STEMI after PCI. Conclusion: fQRS, Tpec, and QTd are the risk factors for MAE in acute STEMI patients after PCI.

参考文献/References:

[1]肖文涛,王宪沛,高传玉,等.急性心肌梗死溶栓前后校正QT间期、校正Tpe间期、Tpe/QT的变化及其预测价值[J].中华心血管病杂志,2012,40(6):473
[2]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.急性ST段抬高型心肌梗死诊断和治疗指南[J].中华心血管病杂志,2010,38(8):675
[3]Pietrasik G, Goldenberg I,Zdzienicka J,et al.Prognostic significance of fragmented QRS complex for predicting the risk of recurrent cardiac events in patients with Qwave myocardial infarction[J].Am J Cardiol,2007,100(4):583
[4]Maehara K,Kokubun T,Awano N, et al. Detection of abnormal highfrequency components in the QRS complex by the wavelet transform in patients with idiopathic dilated cardiomyopathy [J].Jpn Circ J,1999,63(1):25
[5]Calore C,Cacciavillani L,Boffa GM,et al.Contrast enhanced cardiovascular magnetic resonance in primary and ischemic dilated cardiomyopathy[J].J Cardiovasc Med (Hagerstown) 2007,8(10):821
[6]Stevenson WG,Soejima K. Catheter ablation for ventricular tachycardia[J]. Circulation, 2007,115(21):2750
[7]Glukhov AV,Fedorov VV,Lou Q,et al .Transmural dispersion of repolarization in failing and nonfailing human ventricle[J].Circ Res,2010,106(5):981
[8]Yan GX,Joshi A,Guo D,et al.Phase 2 reentry as a trigger to initiate ventricular fibrillation during early acute myocardial ischemia[J].Circulation, 2004, 110(9):1036
[9]Watanabe N,Kobayashi Y,Tanno K,et al.Transmural dispersion of repolarization and ventricular tachyarrhythmias[J].J Electrocardiol,2004,37(3):191
[10]Antzelevitch C,Sicouri S,Di Diego JM, et al. Does Tpeaktend provide an index of transmural dispersion of repolarization?[J].Heart Rhythm,2007,4(8):1114
[11]刘莹,黄永麟.QT间期离散度的发生机制[J].临床心血管病杂志,2001,17(9):391

相似文献/References:

[1]张东铭),张苏河)#,徐占稳),等.糖尿病大鼠心肌梗死后非梗死区心肌细胞凋亡和增殖检测[J].郑州大学学报(医学版),2010,(02):259.
 ZHANG Dongming),ZHANG Suhe),XU Zhanwen),et al.Study of apoptosis and proliferation of myocardium in noninfrarction area after myocardial infraction of rat model of diabetes mellitus[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2010,(05):259.
[2]蒋学俊△,王涛.水凝胶注射治疗心肌梗死的现状与展望[J].郑州大学学报(医学版),2009,(02):227.
[3]汪涛),李恩),孙利强),等.瑞替普酶治疗急性心肌梗死效果观察[J].郑州大学学报(医学版),2009,(04):864.
[4]张艳,赵晓燕,李蕊,等.超声斑点追踪技术对心肌梗死患者PCI术前后左室短轴局部心肌运动的评价[J].郑州大学学报(医学版),2010,(05):854.
[5]佘亚鹏,赵新民,司定然,等. 冠心病左室心肌局部收缩功能异常的二维斑点追踪成像检测*[J].郑州大学学报(医学版),2011,(02):279.
 [J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2011,(05):279.
[6]朱记法,李凌,张晓.急诊冠脉介入治疗时间对急性心肌梗死患者炎症及心肌损伤的影响[J].郑州大学学报(医学版),2011,(06):931.
[7]陈杰,张丽华#,牛少辉.缬沙坦对大鼠急性心肌梗死后F肌动蛋白与热休克蛋白27表达的影响[J].郑州大学学报(医学版),2013,(01):84.
 CHEN Jie,ZHANG Lihua,NIU Shaohui.Effects of valsartan on expressions of Factin and HSP27 in acute myocardial infarction rats[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2013,(05):84.
[8]樊清波),李小威)#,简立国),等.三七总皂苷对大鼠心肌梗死后血管新生及微小RNA21表达的影响[J].郑州大学学报(医学版),2014,(01):48.
 FAN Qingbo#,LI Xiaowei#,JIAN Liguo#,et al.Effects of panax notoginseng saponins on angiogenesis and miRNA21 expression in rats with myocardial infarction[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2014,(05):48.
[9]黄永亮)△,李恩),汪涛).瑞舒伐他汀对心肌梗死后大鼠心肌组织中αSMA、 TGFβ1表达的影响*[J].郑州大学学报(医学版),2015,(02):232.
 HUANG Yongliang,LI En,WANG Tao.Effects of rosuvastatin on expressions of αSMA and TGFβ1 in myocardial tissue of rats with myocardial infarction[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2015,(05):232.
[10]张清丽,苏士美#,尹咪咪,等.基于心电特征参数的心肌梗死疾病辅助诊断模型的建立*[J].郑州大学学报(医学版),2017,(02):151.[doi:10.13705/j.issn.1671-6825.2017.02.011]
 ZHANG Qingli,SU Shimei,YIN Mimi,et al.Establishment of myocardial infarction disease-diagnosis model based on ECG characteristic parameters[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2017,(05):151.[doi:10.13705/j.issn.1671-6825.2017.02.011]

更新日期/Last Update: 2013-09-01