冠状动脉完全闭塞病变患者碎裂QRS波与PCI术后心功能改善的关系

摘要

Objective To observe the changes of cardiac function after percutaneous coronary intervention ( PCI) and relationship between them and fragmented QRS (fQRS ) complex in the patients with coronary total occlusion ( CTO ) . Methods The patients ( n=126 ) with CTO were chosen from Jun. 2006 to Oct. 2011 and divided into fQRS ( n=48 ) and non-fQRS group ( n=78 ) according to the QRS complex types in ECG. The difference in the changes of cardiac function was analyzed between two groups after PCI for 6 months. Results After PCI in two groups, left ventricular ejection fraction ( LVEF ) increased, left ventricular end-diastolic volume index ( LVEDVI ) decreased, and the distance of 6-minute walk test ( 6MWT ) increased significantly. Compared with non-fQRS group, fQRS group had more significant increase of LVEF [ ( 50.09 ± 4.06 ) % vs.( 54.04±3.11 ) %, P<0.05], more significant decrease of LVEDVI [ ( 79.00 ± 8.19 ) mL/m2 vs. ( 76.58± 6.19 ) mL/m2, P<0.05] and longer distance of 6MWT [ ( 439.60 ± 84.46 ) m vs. ( 449.42 ± 100.99 ) m, P <0.05]. Conclusion PCI can improve the cardiac function in the patients with CTO, which is more significant in the patients with fQRS than in those without fQRS.%目的 观察冠状动脉完全闭塞病变患者接受经皮冠状动脉介入治疗(PCI)术后心功能的改善情况与合并QRS波碎裂的关系.方法 纳入2006年6月～2011年10月完全闭塞病变患者126例,根据入院时心电图的QRS波形态分为碎裂QRS波组(fQRS组,n=48)和无碎裂QRS波组(nfQRS组,n=78),分析两组患者PCI术后6个月的心功能改善情况有无差异.结果 两组患者经PCI治疗后左室射血分数(LVEF)增加,左室舒张末容积指数(LVED VI)减少,同时6分钟步行试验距离也较前明显增加,但与nfQRS波组相比,fQRS波组患者LVEF [(54.04士3.11)% vs.(50.09±4.06)%,P＜0.05]增加更明显,LVEDVI[(76.58士6.19)ml/m2 vs.(79.00±8.19)ml/m2,P＜0.05]减少更明显,同时6分钟步行试验显示步行距离更长[(449.42±100.99)m vs.(439.60士84.46)m,P＜0.05].结论 介入治疗能够改善冠状动脉完全闭塞患者心功能,而且合并fQRS波的患者较不合并fQRS波的患者改善更加明显.