中华心律失常学杂志
中華心律失常學雜誌
중화심률실상학잡지
CHINESE JOURNAL OF CARDIAC ARRHYTHMIAS
2014年
5期
368-371
,共4页
王英丽%吕金兰%马淑英%马龙乐%杨文波%张媛%梁拓%王乐信
王英麗%呂金蘭%馬淑英%馬龍樂%楊文波%張媛%樑拓%王樂信
왕영려%려금란%마숙영%마룡악%양문파%장원%량탁%왕악신
陈旧性心肌梗死%病理性Q波%碎裂QRS波%室性心律失常
陳舊性心肌梗死%病理性Q波%碎裂QRS波%室性心律失常
진구성심기경사%병이성Q파%쇄렬QRS파%실성심률실상
Old myocardial infarction%Pathological Q waves%Fratgmented QRS complex%Ventricular arrhythmia
目的 探讨不同部位陈旧性心肌梗死(old myocardial infarction,OMI)心电图QRS波特征和碎裂QRS波(fragmented QRS complex,fQRS)的发生率及其时限与室性心律失常的关系.方法 选择2009年4月至2012年4月在山东省聊城市人民医院确诊为心肌梗死的患者335例进行心电图检查,根据QRS波形态分为病理性Q波组(96例)、fQRS波组(158例)、两者均有组(42例)和两者均无组(123例);根据OMI的不同部位分为前壁组(61例)、下壁组(40例)和侧壁组(15例);按照fQRS时限分为fQRS时限≥110 ms组(23例)和fQRS时限＜110 ms组(93例).对各组数据进行统计学分析.对所有患者进行24h动态心电图检查,统计各组患者室性心律失常的发生情况并进行分析.结果 ①335例OMI患者心电图分析:fQRS波发生率明显高于病理性Q波的发生率(P＜0.01),不同部位OMI患者fQRS波的发生率之间差异无统计学意义(P＞0.05);②fQRS波组不同部位OMI(前壁、下壁、侧壁)患者室性心律失常的发生率差异无统计学意义(P＞0.05);③fQRS时限≥110 ms组室性心律失常发生率高于fQRS时限＜110 ms组.结论 OMI患者心电图fQRS波发生率高于病理性Q波;不同部位OMI心电图fQRS波发生率及其与室性心律失常关系差异无统计学意义;fQRS时限延长可致室性心律失常的发生率增加.提示fQRS波可提高OMI的诊断率,对OMI室性心律失常及其心脏事件的发生具有预警作用.
目的 探討不同部位陳舊性心肌梗死(old myocardial infarction,OMI)心電圖QRS波特徵和碎裂QRS波(fragmented QRS complex,fQRS)的髮生率及其時限與室性心律失常的關繫.方法 選擇2009年4月至2012年4月在山東省聊城市人民醫院確診為心肌梗死的患者335例進行心電圖檢查,根據QRS波形態分為病理性Q波組(96例)、fQRS波組(158例)、兩者均有組(42例)和兩者均無組(123例);根據OMI的不同部位分為前壁組(61例)、下壁組(40例)和側壁組(15例);按照fQRS時限分為fQRS時限≥110 ms組(23例)和fQRS時限＜110 ms組(93例).對各組數據進行統計學分析.對所有患者進行24h動態心電圖檢查,統計各組患者室性心律失常的髮生情況併進行分析.結果 ①335例OMI患者心電圖分析:fQRS波髮生率明顯高于病理性Q波的髮生率(P＜0.01),不同部位OMI患者fQRS波的髮生率之間差異無統計學意義(P＞0.05);②fQRS波組不同部位OMI(前壁、下壁、側壁)患者室性心律失常的髮生率差異無統計學意義(P＞0.05);③fQRS時限≥110 ms組室性心律失常髮生率高于fQRS時限＜110 ms組.結論 OMI患者心電圖fQRS波髮生率高于病理性Q波;不同部位OMI心電圖fQRS波髮生率及其與室性心律失常關繫差異無統計學意義;fQRS時限延長可緻室性心律失常的髮生率增加.提示fQRS波可提高OMI的診斷率,對OMI室性心律失常及其心髒事件的髮生具有預警作用.
목적 탐토불동부위진구성심기경사(old myocardial infarction,OMI)심전도QRS파특정화쇄렬QRS파(fragmented QRS complex,fQRS)적발생솔급기시한여실성심률실상적관계.방법 선택2009년4월지2012년4월재산동성료성시인민의원학진위심기경사적환자335례진행심전도검사,근거QRS파형태분위병이성Q파조(96례)、fQRS파조(158례)、량자균유조(42례)화량자균무조(123례);근거OMI적불동부위분위전벽조(61례)、하벽조(40례)화측벽조(15례);안조fQRS시한분위fQRS시한≥110 ms조(23례)화fQRS시한＜110 ms조(93례).대각조수거진행통계학분석.대소유환자진행24h동태심전도검사,통계각조환자실성심률실상적발생정황병진행분석.결과 ①335례OMI환자심전도분석:fQRS파발생솔명현고우병이성Q파적발생솔(P＜0.01),불동부위OMI환자fQRS파적발생솔지간차이무통계학의의(P＞0.05);②fQRS파조불동부위OMI(전벽、하벽、측벽)환자실성심률실상적발생솔차이무통계학의의(P＞0.05);③fQRS시한≥110 ms조실성심률실상발생솔고우fQRS시한＜110 ms조.결론 OMI환자심전도fQRS파발생솔고우병이성Q파;불동부위OMI심전도fQRS파발생솔급기여실성심률실상관계차이무통계학의의;fQRS시한연장가치실성심률실상적발생솔증가.제시fQRS파가제고OMI적진단솔,대OMI실성심률실상급기심장사건적발생구유예경작용.
Objective To investigate the electrocardiogram (ECG) features and the relationship between the incidence of the fragmented QRS complex(fQRS)with its duration and ventricular arrhythmia in patients with old myocardial infarction(OMI).Methods (1)Three hundreds and thirty-five patients with OMI were enrolled.According to the morphologies of QRS wave,patients were divided into four groups-pathological Q wave group (96 patients),fQRS group (158 patients),pathological Q wave plus fQRS group (42 patients),and without patological Q wave and fQRS group (123 patients).According to the site of myocardial infarction,patients were divided into three groups-anterior wall group (61 patients),inferior wall group (40 patients),and lateral wall group (15 patients); according to fQRS duration,they were divided into two groups-fQRS duration ≥ 110 ms group and fQRS duration＜ 110 ms group.The data of each group was collected and analyzed.(2) Each patient underwent 24 h dynamic ECG examination to evaluate ventricular arrhythmia.Results (1) Based on the ECG in 335 patients with OMI,the frequency of fQRS was higher than that of pathological Q wave (P＜0.01).However,the frequency of fQRS in different OMI had no statistic difference (P＞0.05).(2) In fQRS group,the incidence of ventricular arrhythmia in different OMI had no statistic difference (P＞0.05).(3) The incidence of ventricular arrhythmia in the fQRS duration ≥ 110 ms group was higher than that in patients with fQRS duration＜110 ms.Conclusion In patients with OMI,the incidence of fQRS is higher than that of pathological Q wave.However,the frequency of fQRS complexes and that of ventricular arrhythmia in different OMI have no statistic difference.The prolonged QRS duration may increase the occurrence of ventricular arrhythmia.The evaluation of fQRS may be useful in the diagnosis of OMI,and it could be helpful in predicting occurrence of ventricular arrhythmia.
