V2V3导联碎裂QRS波对冠心病的预测价值

目的:探讨V2V3导联碎裂QRS对冠心病的预测价值。方法:回顾性分析680例患者冠脉造影的结果,并与冠脉造影前常规心电图检查结果进行对比分析,多因素Logistic回归分析影响冠心病和左前降支狭窄独立的预测因素。结果:640例患者中,Q(+)组74例(11.6%),Q(-)组566例(88.4%)。冠脉造影发现355例(55.5%)至少一支冠脉狭窄,其中Q(+)组58例(78.4%),Q(-)组297例(52.5%),Q(+)组冠脉狭窄发生率明显高于Q(-)组(P<0.001)。经多因素Logistic回归分析显示:QRS波起始有Q波(OR=2.454,95%CI1.061～5.681,P<0.001)、年龄>65岁(OR=1.109,95%CI1.086～1.133,P<0.001)和男性(OR=1.574,95%CI1.010～2.432,P<0.05)是冠心病和左前降支狭窄独立的预测因素。结论:V2或V3导联QRS波起始有Q波,伴或不伴Q波切迹对冠心病有独立预测价值,尤其对左前降支狭窄有预测价值。

Diagnostic significance to the coronary artery disease with fragmented QRS wave in precordial leads V2 or V3

Objective To evaluate the clinical prediction efficiency for coronary artery disease with the fragmented QRS complex in leads V2 or V3.Methods ECG of 680 consecutive patients was retrospective analyzed after and front coronary angiography.Multiple logistic regression model was used for the analysis of sensitive independent predictor about coronary artery disease(CAD) and left anterior descending artery(LAD).Results In 640 patients,the Q(+) group 74(11.6%),Q(-) group 566(88.4%).CAD 355(55.5%) patients at least one coronary artery stenosis,the number of patients with significant coronary stenosis was 58(78.4%) Q(+) group and 297(52.5%) Q(-) group(P < 0.001).Multiple logistic regression analysis revealed:the significant independent predictors in the diagnosis of CAD or LAD stenosis,such as presence of Q wave(OR = 2.454,95%CI 1.061 ～ 5.681,P < 0.001),age(> 65years)(OR = 1.109,95%CI 1.086 ～ 1.133,P < 0.001),male sex(OR = 1.574,95%CI 1.010～2.432,P < 0.05).Conclusion The QRS wave in V2 or V3 with or without early fragmentation could be significantly predicted presence of CAD,especially significant in stenosis of the LAD.