非S T段抬高急性冠脉综合征患者碎裂Q RS波的临床分析

目的：探讨碎裂QRS波（fQRS）与非ST段抬高急性冠脉综合征（NSTE-ACS）患者危险分层及近期预后的关系。方法随机选择NSTE-ACS 患者160例，其中高危者72例，非高危（中、低危）者88例。比较fQRS在高危及非高危NSTE-ACS 患者中的发生率，并比较fQRS组与无fQRS组NSTE-ACS患者住院期间心脏事件的发生率。结果 NSTE-ACS 高危患者中有fQRS者20例（27．78％），非高危患者中有fQRS者12例（13．63％），组间比较差异有统计学意义（P＜0．05）。fQRS组室性心律失常、心力衰竭（LVEF≤40％）、心源性休克、心源性死亡的发生率分别为68．75％、43．75％、18．75％和12．5％；而无 fQRS 组分别为45．31％、21．88％、5．47％和1．56％，两组间比较差异均有统计学意义（P＜0．05）。结论 NSTE-ACS高危患者fQRS发生率高。出现fQRS的NSTE-ACS患者，住院期间心脏事件发生率高，故fQRS可作为预测NSTE-ACS近期预后及筛查高危患者的新指标。

Clinical analysis of fragmented QRS complex in non-ST segment elevation acute coronary syndrome patients

Objective To explore the relationship between fragmented QRS complex （fQRS ） and the risk stratification and short-term prognosis of non-ST segment elevation acute coronary syn-drome（NSTE-ACS）patients.Methods One hundred and sixty NSTE-ACS patients were randomly selected,including 72 high-risk cases,and 88 non-high-risk（moderate-and low-risk）cases.Be-tween high-risk and non-high-risk NSTE-ACS patients,the incidence of fQRS was compared.Be-tween fQRS group and non-fQRS group,the incidence of cardiac events of NSTE-ACS patients in hospital was made comparative analysis.Results The incidence of fQRS among high-risk NSTE-ACS patients（20 case,27.78%）was higher than that of non-high-risk NSTE-ACS patients（12 case,13.63%）,with statistically significant difference（P〈0.05）.Among patients with fQRS, the incidences of ventricular arrhythmias,heart failure（LVEF≤40%）,cardiogenic shock,and car-diac death were 68.75%,43.75%,18.75%,and 12.5%,respectively while the incidences of the above cardiac events were separately 45.31%,21.88%,5.47%,and 1.56% in non-fQRS group.And the differences between the two groups were all statistically significant （P 〈0.05 ）. Conclusion The incidence of fQRS among high-risk NSTE-ACS patients was higher,and among NSTE-ACS patients with fQRS,the incidence of cardiac events in hospital was higher,too.There-fore,fQRS may serve as a new index for predicting short-term prognosis of NSTE-ACS and screening patients with a high risk of NSTE-ACS.