论文部分内容阅读
目的 :探讨伴有QRS波终末变形的急性心肌梗死 (AMI)患者经皮冠状动脉 (冠脉 )介入 (PCI)及梗死相关冠脉再通时间对其预后的影响。方法 :将 2 38例初发AMI患者按是否行PCI治疗分为PCI组及非PCI组 ;两组中根据心电图QRS波终末变形分为QRS +(qR型导联的J点抬高 >5 0 % ,R波或Rs型导联的s波消失 )及QRS - ;PCI组中又分为急诊PCI(起病后 12h内行PCI)及择期PCI两亚组。比较QRS +急诊PCI亚组与其他组住院期间死亡率及随访期间 [平均 (12 .6 5± 1.4 6 )个月 ]死亡率、超声心动图左室射血分数 (LVEF)、LVEF <4 0 %的例数、左室舒张期内径 (LVD)等。结果 :急诊PCI的QRS +患者住院期间死亡率明显低于非PCI的QRS+患者 (P <0 .0 5 ) ;前者随访期死亡率明显低于、LVEF明显大于择期PCI及非PCI的QRS +患者 ;且LVEF <4 0 %的例数及LVD值明显低于择期PCI及非PCI的QRS +患者 (均P <0 .0 5 )。结论 :QRS波终末变形的AMI患者的预后与相关冠脉是否及时再通有关 ,如能及早再通仍可改善其预后
Objective: To investigate the effect of percutaneous coronary intervention (PCI) and infarct-related coronary recanalization time on the prognosis of patients with acute myocardial infarction (AMI) accompanied by terminal deformation of QRS. Methods: Two hundred thirty-eight patients with initial AMI were divided into PCI group and non-PCI group according to whether PCI was performed or not. In the two groups, QRS + (J-point elevation> 5 0%, R wave or Rs type s wave disappears) and QRS -; PCI group is divided into emergency PCI (PCI within 12h after onset) and elective PCI two subgroups. Comparisons of in-hospital mortality and follow-up [mean (12.6 ± 1.4 6) months] mortality, echocardiographic left ventricular ejection fraction (LVEF), LVEF <40 in the QRS + emergency PCI group and other groups % Of cases, left ventricular diastolic diameter (LVD) and so on. Results: The mortality rate of QRS + patients in emergency PCI was significantly lower than that in non-PCI QRS + patients (P <0.05). The former had significantly lower follow-up mortality and LVEF than those of QRS + patients with elective PCI and non-PCI ; And the number of cases with LVEF <40% and the LVD values were significantly lower than those of elective PCI and non-PCI QRS + patients (all P <0.05). Conclusions: The prognosis of AMI patients with terminal deformation of QRS wave is related to whether the relevant coronary recanalization is timely. If they can be recanalized early, their prognosis may be improved