碎裂QRS波与冠心病病人冠状动脉病变的相关性研究
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摘要
目的探讨碎裂QRS波(fQRS)与冠心病病人冠状动脉病变程度之间的关系。方法选取2013年1月—2016年1月我院收治的253例冠心病病人作为研究对象,所有病人均接受动态心电图检查,根据其心电图检查结果分为碎裂fQRS组(138例)、无fQRS组(115例),比较fQRS组、无fQRS组的冠状动脉病变范围、冠状动脉狭窄程度以及室性心律失常发生情况。结果 fQRS组的多支病变、重度狭窄、不稳定型心绞痛发生率均明显高于无fQRS组(P <0.05);fQRS组室性心动过速、室性期前收缩、室性逸搏心律等心律失常发生率均明显高于无fQRS组(P <0.05);fQRS波与冠心病病人冠状动脉病变支数、冠状动脉狭窄程度、心绞痛严重程度、室性心律失常均呈正相关(P <0.05)。结论碎裂QRS波可在一定程度上反映冠心病病人的冠状动脉病变程度,可作为冠状动脉病变病情监测及预后预测的重要指标。
Objective To investigate the relationship between fragmented QRS wave(fQRS)and coronary artery lesion in patients with coronary heart disease(CHD).Methods Two hundreds and fifty-three patients with CHD admitted to our hospital from January 2013 to January 2016 were selected as subjects.All patients underwent Holter dynamic electrocardiography.According to the results of electrocardiogram,they were divided into fQRS group(138 cases)and non-fQRS group(115 cases).The range of coronary lesions,degree of coronary artery stenosis,and the incidence of ventricular arrhythmia were compared between fQRS group and non-fQRS group.Results The incidence of multi-vessel lesions,severe stenosis,and unstable angina pectoris in the fQRS group was significantly higher than that in the non-fQRS group(P <0.05).The incidence of arrhythmia such as ventricular tachycardia,ventricular premature contraction,and ventricular escape rhythm in the fQRS group was significantly higher than that in the non-fQRS group(P <0.05).The fQRS wave was positively correlated with the number of coronary artery lesions,the degree of coronary artery stenosis and the severity of angina pectoris in patients with coronary heart disease(P <0.05),and was also closely related to the occurrence of ventricular arrhythmia(P <0.05).Conclusion The fQRS can reflect the degree of coronary artery disease in patients with CHD to a certain extent,and can be used as an important indicator for monitoring and prognosis of CHD.
Objective To investigate the relationship between fragmented QRS wave(fQRS)and coronary artery lesion in patients with coronary heart disease(CHD).Methods Two hundreds and fifty-three patients with CHD admitted to our hospital from January 2013 to January 2016 were selected as subjects.All patients underwent Holter dynamic electrocardiography.According to the results of electrocardiogram,they were divided into fQRS group(138 cases)and non-fQRS group(115 cases).The range of coronary lesions,degree of coronary artery stenosis,and the incidence of ventricular arrhythmia were compared between fQRS group and non-fQRS group.Results The incidence of multi-vessel lesions,severe stenosis,and unstable angina pectoris in the fQRS group was significantly higher than that in the non-fQRS group(P <0.05).The incidence of arrhythmia such as ventricular tachycardia,ventricular premature contraction,and ventricular escape rhythm in the fQRS group was significantly higher than that in the non-fQRS group(P <0.05).The fQRS wave was positively correlated with the number of coronary artery lesions,the degree of coronary artery stenosis and the severity of angina pectoris in patients with coronary heart disease(P <0.05),and was also closely related to the occurrence of ventricular arrhythmia(P <0.05).Conclusion The fQRS can reflect the degree of coronary artery disease in patients with CHD to a certain extent,and can be used as an important indicator for monitoring and prognosis of CHD.
引文
[1]林晓明,杨希立,刘鹤龄,等.碎裂QRS波与冠状动脉病变的关系研究[J].中国全科医学,2013,16(11):1238-1239;1243.
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[4]段雯婷,马向红,崔立军,等.碎裂QRS波与急性心肌梗死急诊介入治疗后ST段回落不良的关系[J].中华心血管病杂志,2014,42(5):400-405.
[5]罗朝军,叶玉春,马娜,等.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[J].中国循证心血管医学杂志,2013,5(2):153-155.
[6]BARANCHUK A,MIRANDA R,FEMENíA F,et al.Chagas′cardiomyopathy and Fragmented QRS.Re:QRS fragmentation as a marker of arrhythmias in coronary artery disease,in cardiomyopathies and ion channel diseases[J].International Journal of Cardiology,2012,160(2):151-152.
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[8]汤振,刘志忠,刘发军,等.冠状动脉慢性完全闭塞病变患者碎裂QRS波与血运重建术后左心室心功能改善的研究[J].中国介入心脏病学杂志,2016,24(7):385-389.
[9]董秋菊,王雄,乔占瑞,等.碎裂QRS波在冠心病患者中的临床意义[J].中西医结合心脑血管病杂志,2012,10(5):539-540.
[10]李英兰,李跃荣.碎裂QRS波在冠心病心肌缺血诊断中的应用价值[J].中国当代医药,2014,21(33):43-45.
[11]谢晓红,张晓红,周昌清,等.碎裂QRS波与冠状动脉病变相关性研究[J].安徽医学,2016,37(2):160-163.
[12]姜忠滨,王怀新.碎裂QRS波在急性心肌梗死中的应用进展[J].中国急救医学,2014,34(5):473-476.
[13]Peters S.QRS fragmentation as a marker of arrhythmias in coronary artery disease,in cardiomyopathies and ion channel diseases[J].International Journal of Cardiology,2012,158(1):176-177.
[14]李昕,郜玲,石亚君,等.碎裂QRS波与冠心病患者冠状动脉病变程度的关系研究[J].中华老年心脑血管病杂志,2013,5(5):465-467.
[15]KADI H,INANIR A,Habiboglu A,et al.Frequency of fragmented QRS on ECG is increased in patients with rheumatoid arthritis without cardiovascular disease:apilot study[J].Modern Rheumatology,2012,22(2):238-242.
[2]KADI H,KEVSER A,OZTURK A,et al.Fragmented QRS complexes are associated with increased left ventricular mass in patients with essential hypertension[J].Ann Noninvasive Electrocardiol,2013,18(6):547-554.
[3]杨帆,张静华,李平,等.冠状动脉慢血流现象与心电图碎裂QRS波及相关因素的研究[J].实用医学杂志,2016,32(12):2011-2014.
[4]段雯婷,马向红,崔立军,等.碎裂QRS波与急性心肌梗死急诊介入治疗后ST段回落不良的关系[J].中华心血管病杂志,2014,42(5):400-405.
[5]罗朝军,叶玉春,马娜,等.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[J].中国循证心血管医学杂志,2013,5(2):153-155.
[6]BARANCHUK A,MIRANDA R,FEMENíA F,et al.Chagas′cardiomyopathy and Fragmented QRS.Re:QRS fragmentation as a marker of arrhythmias in coronary artery disease,in cardiomyopathies and ion channel diseases[J].International Journal of Cardiology,2012,160(2):151-152.
[7]周江花.心电图检测中碎裂QRS波对临床冠心病诊断的价值观察[J].中国医药导刊,2013,15(12):1991;1993.
[8]汤振,刘志忠,刘发军,等.冠状动脉慢性完全闭塞病变患者碎裂QRS波与血运重建术后左心室心功能改善的研究[J].中国介入心脏病学杂志,2016,24(7):385-389.
[9]董秋菊,王雄,乔占瑞,等.碎裂QRS波在冠心病患者中的临床意义[J].中西医结合心脑血管病杂志,2012,10(5):539-540.
[10]李英兰,李跃荣.碎裂QRS波在冠心病心肌缺血诊断中的应用价值[J].中国当代医药,2014,21(33):43-45.
[11]谢晓红,张晓红,周昌清,等.碎裂QRS波与冠状动脉病变相关性研究[J].安徽医学,2016,37(2):160-163.
[12]姜忠滨,王怀新.碎裂QRS波在急性心肌梗死中的应用进展[J].中国急救医学,2014,34(5):473-476.
[13]Peters S.QRS fragmentation as a marker of arrhythmias in coronary artery disease,in cardiomyopathies and ion channel diseases[J].International Journal of Cardiology,2012,158(1):176-177.
[14]李昕,郜玲,石亚君,等.碎裂QRS波与冠心病患者冠状动脉病变程度的关系研究[J].中华老年心脑血管病杂志,2013,5(5):465-467.
[15]KADI H,INANIR A,Habiboglu A,et al.Frequency of fragmented QRS on ECG is increased in patients with rheumatoid arthritis without cardiovascular disease:apilot study[J].Modern Rheumatology,2012,22(2):238-242.