国际心血管病杂志
國際心血管病雜誌
국제심혈관병잡지
INTERNATIONAL JOURNAL OF CARDIOVASCULAR DISEASE
2014年
4期
271-273
,共3页
袁敏杰%魏盟%李京波%胡伟国%陆志刚%陈欣
袁敏傑%魏盟%李京波%鬍偉國%陸誌剛%陳訢
원민걸%위맹%리경파%호위국%륙지강%진흔
急性冠脉综合征%心室晚电位%QRS 持续时间%QRS 终末 40 ms 均方根电压值%QRS 终末低于 40 μV 低振幅波持续时间
急性冠脈綜閤徵%心室晚電位%QRS 持續時間%QRS 終末 40 ms 均方根電壓值%QRS 終末低于 40 μV 低振幅波持續時間
급성관맥종합정%심실만전위%QRS 지속시간%QRS 종말 40 ms 균방근전압치%QRS 종말저우 40 μV 저진폭파지속시간
Acute coronary syndrome%Ventricular late potential%fQRSd%RMS(40)%LAS(40)
目的:评价心室晚电位(ventricular late potential,VLP)对于急性冠脉综合征(ACS)患者的预后价值。方法:选择为确诊 ACS 并接受冠状动脉造影(CAG)及经皮冠状动脉介入治疗(PCI)的患者134例,在发病2~4周内行 VLP 检查。采用美国 GE公司心电工作站对静息状态下的患者进行检测,通过高频平均心电图获得经滤波后 QRS持续时间(fQRSd)、QRS 终末40 ms 均方根电压值[RMS(40)],QRS 终末低于40μV 低振幅波持续时间[LAS (40)]并记录。随访时间至少半年,观察患者主要心血管事件(MACE)发生情况。结果:134例患者中,VLP 阳性13例,阴性121例,阳性率9.7%。随访时间中位数7.3个月,发生 MACE 18例,其中 VLP 阳性5例,阴性13例。VLP 预测 ACS 患者发生 MACE 敏感性和特异性分别为27.8%和93.1%,logistic 回归分析提示阳性结果对于 MACE 的预测有重要意义(P <0.05)。LAS(40)异常对 ACS 患者预后具有独立的预测价值(P <0.05),其阳性预测值和阴性预测值分别为27.8%和97.4%。fQRSd 阳性预测值和阴性预测值分别为33.3%和90.5%。RMS(40)阳性预测值和阴性预测值分别为16.7%和91.4%。结论:围术期 VLP 阳性及 LAS(40)异常的 ACS 患者在恢复期发生 MACE 的风险增高。
目的:評價心室晚電位(ventricular late potential,VLP)對于急性冠脈綜閤徵(ACS)患者的預後價值。方法:選擇為確診 ACS 併接受冠狀動脈造影(CAG)及經皮冠狀動脈介入治療(PCI)的患者134例,在髮病2~4週內行 VLP 檢查。採用美國 GE公司心電工作站對靜息狀態下的患者進行檢測,通過高頻平均心電圖穫得經濾波後 QRS持續時間(fQRSd)、QRS 終末40 ms 均方根電壓值[RMS(40)],QRS 終末低于40μV 低振幅波持續時間[LAS (40)]併記錄。隨訪時間至少半年,觀察患者主要心血管事件(MACE)髮生情況。結果:134例患者中,VLP 暘性13例,陰性121例,暘性率9.7%。隨訪時間中位數7.3箇月,髮生 MACE 18例,其中 VLP 暘性5例,陰性13例。VLP 預測 ACS 患者髮生 MACE 敏感性和特異性分彆為27.8%和93.1%,logistic 迴歸分析提示暘性結果對于 MACE 的預測有重要意義(P <0.05)。LAS(40)異常對 ACS 患者預後具有獨立的預測價值(P <0.05),其暘性預測值和陰性預測值分彆為27.8%和97.4%。fQRSd 暘性預測值和陰性預測值分彆為33.3%和90.5%。RMS(40)暘性預測值和陰性預測值分彆為16.7%和91.4%。結論:圍術期 VLP 暘性及 LAS(40)異常的 ACS 患者在恢複期髮生 MACE 的風險增高。
목적:평개심실만전위(ventricular late potential,VLP)대우급성관맥종합정(ACS)환자적예후개치。방법:선택위학진 ACS 병접수관상동맥조영(CAG)급경피관상동맥개입치료(PCI)적환자134례,재발병2~4주내행 VLP 검사。채용미국 GE공사심전공작참대정식상태하적환자진행검측,통과고빈평균심전도획득경려파후 QRS지속시간(fQRSd)、QRS 종말40 ms 균방근전압치[RMS(40)],QRS 종말저우40μV 저진폭파지속시간[LAS (40)]병기록。수방시간지소반년,관찰환자주요심혈관사건(MACE)발생정황。결과:134례환자중,VLP 양성13례,음성121례,양성솔9.7%。수방시간중위수7.3개월,발생 MACE 18례,기중 VLP 양성5례,음성13례。VLP 예측 ACS 환자발생 MACE 민감성화특이성분별위27.8%화93.1%,logistic 회귀분석제시양성결과대우 MACE 적예측유중요의의(P <0.05)。LAS(40)이상대 ACS 환자예후구유독립적예측개치(P <0.05),기양성예측치화음성예측치분별위27.8%화97.4%。fQRSd 양성예측치화음성예측치분별위33.3%화90.5%。RMS(40)양성예측치화음성예측치분별위16.7%화91.4%。결론:위술기 VLP 양성급 LAS(40)이상적 ACS 환자재회복기발생 MACE 적풍험증고。
Objective:To evaluate the prognostive value of ventricular late potentials (VLP)in patients with acute coronary syndrome (ACS). Methods:A total of 134 patients with ACS who underwent coronary angiography (CAG)and percutaneous coronary intervention (PCI)were enrolled in this study.VLP was detected by electrocardiograms (ECG)workstation provided by GE company in 2~4 weeks after onset of ACS on patients in resting state.Parameters of VLP such as fQRSd,RMS(40) and LAS(40)were obtained from high frequency signal-averaged ECG.All the patients were followed up for at least half a year to observe the occurrence of major adverse cardiac events (MACE). Results:Among all the patients,13 cases were VLP-positive and 121 were negative with a positive rate of 9.7%. During an average follow-up of 7.3 months,MACE occurred in 18 cases,including 5 VLP-positive ones and 13 negative ones.VLP positive had certain predictive value for MACE,with 27.8% sensitivity and 93.1 % specificity (P <0.05 ).LAS(40 )had independent predictive value for the prognosis of ACS patients with 27.8% positive predictive value and 97.4% negative predictive value (P <0.05 ).The positive and negative predictive value of fQRSd were 33.3% and 90.5%,while those of LAS(40)were 16.7% and 91 .4%,respectively. Conclusion:ACS patients with positive VLP or abnormal LAS(40) had increased risk for MACE during the recovery period.