PCI术后新发碎裂QRS波对STEMI患者院内主要心血管不良事件的预测价值

目的研究经皮冠状动脉介入术(PCI)后新发碎裂QRS波(fQRS)对ST段抬高型心肌梗死(STEMI)患者院内主要心血管不良事件(MACE)的预测价值。方法选择急诊PCI治疗的急性STEMI患者为研究对象,根据术后是否新发fQRS波分为fQRS组和非fQRS组,比较两组间心肌损伤程度及MACE的差异,采用Logistic回归模型分析MACE的影响因素。结果fQRS组磷酸肌酸激酶同工酶(CK-MB)峰值、心肌肌钙蛋白I(cTnI)峰值、MACE发生率均高于非fQRS组,TIMI血流分级低于非fQRS组(P＜0.05)。经Logistic回归分析,C反应蛋白(hs-CRP)、CK-MB峰值、cTnI峰值、Grace评分、新发fQRS波是MACE的影响因素(P＜0.05)。结论STEMI患者PCI术后新发fQRS波与院内MACE有关,可作为预测MACE的指标。

Predictive value of new appearance of fragmented QRS wave after PCI for cardiovascular adverse events of STEMI patients

Canadian playwright Colleen Murphy''s Pig Girl, prize-winning works of 2016 Governor General''s Award,is based on a real serial killings. The play has been highly praised by the fact that women from indigenous communities in Canada are at high risk of violence and the indifference of police force; however, the play arouses strong opposition and boycott from indigenous communities. There are two focus of controversy:the first is whether sexual abuse and physical violence can be presented directly, and the second is whether the play''s title is an undisguised insult to indigenous people. For the contrasting reaction towards the play, this paper attempt to analyze the controversy through a comparison with other indigenous artists who always emphasise collective mourning and healing when dealing with similar themes. The paper conclude that extreme racial violence is not a forbidden zone for artistic creation, yet when it concerns with such sensitive themes as rape taken as a consistent colonial strategy and the trauma has far from been cured, any artist should not protect their freedom to create at the cost of victims'' feeling. Only in this way, can a piece of work dealing with violence contribute to the implementation of justice without getting involved in ethical argument, and eventually become an ideal intervention of society.