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

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±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.

Changes of cardiac function after percutaneous coronary intervention and relationship between them and fragmented QRS complex in patients with coronary total occlusion

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/m^2, 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.