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目的分析碎裂QRS(fQ RS)波在急性心肌梗死(AMI)中的发生情况及其临床意义。方法选取2014年1月至2015年10月AMI患者90例,经12导联心电图检查分为fQ RS组(A组)33例与无fQ RS组(B组)57例。观察所有患者fQ RS的发生情况、临床表现、临床转归及并发症发生情况。结果 90例患者中fQ RS的发生率为36.7%(33/90),fQ RS的导联部位:ⅢavF导联5例(15.1%),ⅠavL导联13例(39.4%),V4~V6导联15例(45.5%)。A组患者心率失常、左室射血分数(LVEF)降低、梗死范围变大、梗死情况加重发生率高于B组(P<0.05),两组患者心绞痛再发率比较差异未见统计学意义(P>0.05)。B组患者心功能不全、心源性死亡发生率低于A组(P<0.05)。两组患者心源性休克、急性肺水肿、房室传导阻滞比较,差异未见统计学意义(P>0.05)。结论 fQ RS波对AMI患者治疗策略的选择及对患者预后的改善具有重要意义,其可作为早期识别重症AMI的重要指标。
Objective To analyze the occurrence and clinical significance of fragmented QRS (fQ RS) wave in acute myocardial infarction (AMI). Methods Ninety AMI patients from January 2014 to October 2015 were enrolled in this study. Twenty-three patients with fQ RS (group A) and 57 patients without fQ RS (group B) underwent 12-lead electrocardiography. All patients were observed fQ RS occurrence, clinical manifestations, clinical outcomes and complications. Results The incidence of fQ RS was 36.7% (33/90) in 90 patients. The lead of fQ RS was 5 cases (15.1%) in ⅢavF lead, 13 cases (39.4%) in IavL lead, In 15 cases (45.5%). A group of patients with arrhythmia, left ventricular ejection fraction (LVEF) decreased, infarct size became larger, the incidence of infarction aggravated than the B group (P <0.05), the two groups of patients with angina recurrence rate was no significant difference (P> 0.05). Cardiac insufficiency was found in group B, and the incidence of cardiac death was lower than that in group A (P <0.05). There was no significant difference between the two groups in cardiogenic shock, acute pulmonary edema and atrioventricular block (P> 0.05). Conclusion The fQ-RS wave is of great importance for the treatment of patients with AMI and the prognosis of patients with AMI, which can be used as an important indicator of early recognition of severe AMI.