碎裂QRS波与冠状动脉病变相关性研究

目的 探讨碎裂QRS波(fQRS)与急性冠状动脉综合征患者冠状动脉病变之间相关性。方法 收集急性冠状动脉综合征(ACS)患者204例临床资料,其中ST段抬高性心肌梗死(STEMI)75例和非ST段抬高性急性冠状动脉综合征(NST-ACS)129例,根据有无fQRS分为fQRS(+)和fQRS(-)两组,分析fQRS与冠状动脉病变相关性。结果 在fQRS(+)组中,ACS类型、病变血管数、Gensini评分、年龄、性别与fQRS(-)组之间的差异均有统计学意义(P<0.05)。logistic回归分析显示,fQRS波形成与高Gensini评分、三支病变、老年(>65岁)有关(OR=3.234,95%CI:1.386~7.543,P=0.007;OR=2.358,95%CI:1.114~4.992,P=0.025;OR=0.318,95%CI:0.150~0.672,P=0.003)。Spearman相关分析显示fQRS波导联数量与Gensini积分之间呈正相关(r=0.308,P=0.008)。结论 fQRS可作为评估冠状动脉病变范围、程度的一种无创指标。

Study on relationship between fragmented QRS complexes and coronary artery lesions

Objective To evaluate the relationship between the fragmented QRS(fQRS) complexes and the coronary artery lesions in patients with acute coronary syndrome(ACS).Methods A total of 204 patients with ACS, including 75 cases of ST-elevated myocardial infarction(STEMI) and 129 cases of non-ST-elevatedACS(NSTEACS), were retrospectively collected and evaluated in this study.All patients were divided into fQRS(+) group and fQRS(-) group, and the relationship between fQRS and coronary artery lesions were analyzed.Results In the fQRS(+) group, the ACS type, involved vessels, Gensini score, age and sex were of statistically significant differences when compared with those in the fQRS(-) group.Logistic regression analysis demonstrated that high Gensini score, three involved vessels and age >65 years were independent predictors of the presence of fQRS complexes(OR=3.234, 95%CI1.386-7.543, P=0.007;OR=2.358, 95%CI 1.114-4.992, P=0.025;OR=0.318, 95% CI 0.150-0.672, P=0.003, respectively).Spearman correlation analysis showed that the number of leads with fQRS complexes were positively related with the Gensini score(r=0.308, P=0.008).Conclusion The fQRS complexes could be used as a noninvasive indicator for evaluation of the range and severity of coronary artery lesions.