碎裂QRS波对疑诊冠心病患者的冠状动脉狭窄程度和发生恶性心律失常的预测价值

摘要

Objective To study the predictive value of fragmented QRS(fQRS)wave for malignant arrhythmia and the severity of coronary artery stenosis in patients with suspected coronary heart disease. Methods A total of 492 patients with clinically suspected coronary heart disease were selected to perform a retrospective analysis and were hospitalized and underwent selective coronary angiography(CAG)from Baotou Central Hospital from January 2012 to December 2013.According to the standard 12 leads electrocardiogram(ECG)performed in first three days after admission,the subjects were divided into 2 groups: group with fQRS(n=271)and group without fQRS(n=221).The differences of baseline clinical information,the extent of coronary stenosis and the incidence of malignant arrhythmia were evaluated and compared between the 2 groups. Results The positive rate of CAG in fQRS positive group was significantly higher than that of fQRS negative group(86.7% vs. 66.1%,χ2=29.718,P<0.001).In addition,the incidence of malignant arrhythmia in fQRS positive group was significantly higher than that in fQRS negative group(8.1% vs. 3.2%,χ2=5.379,P=0.02). Conclusions The fQRS has a high predictive value for malignant arrhythmia and the severity of coronary artery stenosis in patients with suspected coronary heart disease.%目的 探讨碎裂QRS波(fQRS)对疑诊冠心病患者的冠状动脉狭窄程度和发生恶性心律失常的预测价值.方法 回顾性分析2012年1月至2013年12月在包头市中心医院心内科住院,临床考虑冠心病并行选择性冠状动脉造影的患者492例,根据患者入院后前3 d内心电图有无fQRS波将其分为两组,其中fQRS波阳性组271例,fQRS波阴性组221例,比较两组患者冠状动脉狭窄程度和恶性心律失常发病率的差异.结果 fQRS波阳性组疑诊冠心病患者的冠状动脉造影检查阳性率高于fQRS波阴性组(86.7%比66.1%,χ2=29.718,P<0.001),fQRS波阳性组恶性心律失常发病率也高于fQRS波阴性组(8.1%比3.2%,χ2=5.379,P=0.02).结论 fQRS波对疑诊冠心病患者的冠状动脉狭窄程度和发生恶性心律失常有预测价值.