中国医师杂志
中國醫師雜誌
중국의사잡지
JOURNAL OF CHINESE PHYSICIAN
2014年
9期
1207-1209
,共3页
岑梅珠%金国峰%黄林贤%刘成杰%黄颖珺%叶嘉欣
岑梅珠%金國峰%黃林賢%劉成傑%黃穎珺%葉嘉訢
잠매주%금국봉%황림현%류성걸%황영군%협가흔
心电描记术%利钠肽,脑%心肌梗死/并发症%急性病%心脏病/病因学%心律失常,心性/病因学%休克,心原性
心電描記術%利鈉肽,腦%心肌梗死/併髮癥%急性病%心髒病/病因學%心律失常,心性/病因學%休剋,心原性
심전묘기술%리납태,뇌%심기경사/병발증%급성병%심장병/병인학%심률실상,심성/병인학%휴극,심원성
Electrocardiography%Natriuretic peptide,brain%Myocardial infarction/complications%Acute disease%Heart diseases/etiology%Arrhythmias,cardiac/etiology%Shock,cardiogenic
目的 研究急性心肌梗死(AMI)患者心电图出现碎裂QRS波(fQRS)及脑钠肽(BNP)水平与冠脉病变范围、严重心脏并发症及心源性死亡的相关性.方法 连续入选AMI患者,依据心电图是否出现fQRS分成fQRS组和无fQRS组;应用免疫荧光法对AMI患者进行血浆BNP水平检测.观察两组患者严重心脏事件发生情况及冠脉病变范围;冠脉病变支数与BNP水平的关系.结果 急性心肌梗死患者碎裂QRS波的发生率为34.0％,fQRS波组高度/三度房室阻滞、室速/室颤、心源性休克、心源性死亡发生率高于无fQRS波组(P＜0.05).fQRS波组血浆BNP、左室舒张末内径、多支病变均显著高于无fQRS组(P＜0.01),左室射血分数、单支病变显著低于无fQRS波组(P＜0.01).BNP水平在单支、双支、多支病变组中随着病变支数的增加而逐渐升高.结论 急性心肌梗死患者出现fQRS波易并发严重心律失常,且病死率高,预后差.心电图上fQRS的出现及BNP水平与冠脉病变范围及程度有一定的关系,可作为预测冠脉病变程度的指标,对于多支病变有一定的预测价值.
目的 研究急性心肌梗死(AMI)患者心電圖齣現碎裂QRS波(fQRS)及腦鈉肽(BNP)水平與冠脈病變範圍、嚴重心髒併髮癥及心源性死亡的相關性.方法 連續入選AMI患者,依據心電圖是否齣現fQRS分成fQRS組和無fQRS組;應用免疫熒光法對AMI患者進行血漿BNP水平檢測.觀察兩組患者嚴重心髒事件髮生情況及冠脈病變範圍;冠脈病變支數與BNP水平的關繫.結果 急性心肌梗死患者碎裂QRS波的髮生率為34.0％,fQRS波組高度/三度房室阻滯、室速/室顫、心源性休剋、心源性死亡髮生率高于無fQRS波組(P＜0.05).fQRS波組血漿BNP、左室舒張末內徑、多支病變均顯著高于無fQRS組(P＜0.01),左室射血分數、單支病變顯著低于無fQRS波組(P＜0.01).BNP水平在單支、雙支、多支病變組中隨著病變支數的增加而逐漸升高.結論 急性心肌梗死患者齣現fQRS波易併髮嚴重心律失常,且病死率高,預後差.心電圖上fQRS的齣現及BNP水平與冠脈病變範圍及程度有一定的關繫,可作為預測冠脈病變程度的指標,對于多支病變有一定的預測價值.
목적 연구급성심기경사(AMI)환자심전도출현쇄렬QRS파(fQRS)급뇌납태(BNP)수평여관맥병변범위、엄중심장병발증급심원성사망적상관성.방법 련속입선AMI환자,의거심전도시부출현fQRS분성fQRS조화무fQRS조;응용면역형광법대AMI환자진행혈장BNP수평검측.관찰량조환자엄중심장사건발생정황급관맥병변범위;관맥병변지수여BNP수평적관계.결과 급성심기경사환자쇄렬QRS파적발생솔위34.0％,fQRS파조고도/삼도방실조체、실속/실전、심원성휴극、심원성사망발생솔고우무fQRS파조(P＜0.05).fQRS파조혈장BNP、좌실서장말내경、다지병변균현저고우무fQRS조(P＜0.01),좌실사혈분수、단지병변현저저우무fQRS파조(P＜0.01).BNP수평재단지、쌍지、다지병변조중수착병변지수적증가이축점승고.결론 급성심기경사환자출현fQRS파역병발엄중심률실상,차병사솔고,예후차.심전도상fQRS적출현급BNP수평여관맥병변범위급정도유일정적관계,가작위예측관맥병변정도적지표,대우다지병변유일정적예측개치.
Objective To investigate the acute myocardial infarction (AMI) patient's electrocardiogram appearing fragment QRS wave (fQRS) and brain natriuretic peptide (BNP) level and scope of coronary lesions,severe cardiac complications,and the cor relation of cardiac death.Methods For selected patients with AMI,whether based on electrocardiogram (ECG) appeared in fQRS group and non fQRS groups; immunofluorescence technique was used to detect the plasma BNP level in patients with AMI.Two groups of patients with serious cardiac events and coronary artery lesions scope were observed; Coronary artery lesion count and BNP level were recorded.Results The incidence of fragment QRS wave in patients with AMI was 34.0％,fQRS wave group height/three degree atri oventricular block,ventricular tachycardia/ventricular fibrillation,cardiac shock,cardiac death rate was higher than non fQRS wave group (P ＜0.05).fQRS wave group of plasma BNP and left ventricular end-diastolic diameter,the double branch lesion,multivessel lesions were significantly higher than that of non fQRS group (P ＜ 0.01) ; left ventricular ejection fraction,the single lesion was sig nificantly lower than non fQRS wave group (P ＜0.01).The BNP levels in single,double,and multivessel lesions in the group with the increase of the lesion count were increased.Conclusions The AMI patients with fQRS easily complicated with severe arrhythmia,and case fatality rate was high,the prognosis was poor.fQRS on electrocardiogram (ECG) and BNP level had a certain relationship with range and degree of coronary artery lesions,degree of indexes might be used as a prediction of coronary lesions,and multivessel lesions had certain prediction value.
