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目的探讨早期急性ST段抬高型心肌梗死(STEMI)患者心电图QRS波终末变形与冠脉血管病变和血清高敏肌钙蛋白I(hs-cTnI)的关系。方法根据入院心电图将120例STEMI患者分为QRS波终末变形(QRS+)组81例和无QRS波终末变形(QRS-)组39例,两组均行冠脉造影及检测hs-cTnI。比较两组冠脉血管病变发生情况和hs-cTnI水平。结果(1)QRS+组:男68例(83.95%),女13例(16.05%);QRS-组:男27例(69.23%),女12例(30.77%),两组性别比较差异有统计学意义(P<0.05)。(2)QRS+组患者左前降支病变发生率高于QRS-组,差异有统计学意义(P<0.05),QRS-组患者左回旋支病变发生率高于QRS+组,差异有统计学意义(P<0.01)。(3)QRS+组患者hs-cTnI的水平高于QRS-组,差异有统计学意义(P<0.01)。结论 QRS波终末变形者左前降支病变发病率高、QRS波终末无变形者左回旋支病变发病率高;QRS波终末变形与血清hs-cTnI水平有关。
Objective To investigate the relationship between terminal QRS changes and coronary artery lesions and serum hs-cTnI in patients with early stage STEMI. Methods One hundred and twenty STEMI patients were divided into QRS QRS group (n = 81) and QRS-free group (n = 39) according to admission electrocardiogram. Coronary angiography and hs-cTnI were performed in both groups. The occurrence of coronary artery disease and the level of hs-cTnI in both groups were compared. RESULTS: In QRS + group, there were 68 males (83.95%) and 13 females (16.05%) in QRS group. There were 27 males (69.23%) and 12 females (30.77%) in QRS- Significance (P <0.05). (2) The incidence of left anterior descending coronary artery disease in QRS + group was significantly higher than that in QRS- group (P <0.05). The incidence of left circumflex coronary artery in QRS- group was higher than that in QRS + group (P <0.05) P <0.01). (3) The level of hs-cTnI in QRS + group was higher than QRS-group, the difference was statistically significant (P <0.01). Conclusions The incidence of left anterior descending coronary artery disease is high in the terminal deformation of QRS wave, and the incidence of left circumflex coronary artery disease is high in the end without any deformation of QRS wave. The final deformation of QRS wave is related to the serum hs-cTnI level.