碎裂QRS波在诊断急性心肌梗死中的应用价值

目的：探讨心电图碎裂QRS波(fQRS波)在诊断急性心肌梗死(AMI)的应用价值。方法方便选取该院2010年1月—2015年6月经冠脉造影确诊的急性心肌梗死患者90例与非AMI患者进行对比分析，又根据患者是否存在fQRS或病理性Q波分组，分析fQRS波的分布特性及价值性。结果①下壁出现fQRS的机率(12.22%)较前壁、侧壁(5.6%)、3.3%)高。②病理性Q波(25.56%)敏感性略高于fQRS波者(21.11%)，但病理性Q波者(88.89%和69.70%)均低于fQRS波者特异性(95.56%)及阳性预测值(82.60%)；当两者结合应用时，敏感性和特异性、阳性预测值、阴性性预测值(41.11%、96.67%、92.50%、62.14%)均较高。③在NSTEMI患者中fQRS (38.10%)发生率明显高于病理Q波(14.29%)， fQRS与fQRS合并病理性Q波对比差异有统计学意义(P<0.05)。结论 fQRS波对NSTEMI有一定的诊断价值，可作为心电图诊断急性心肌梗死的一个新指标。

The Application Value of Fragmented QRS wave in the diagnosis of Acute Myocardial Infarction

Objective To explore the application value of Electrocardiogram fragmentation QRS wave (fQRS wave) in the diagnosis of acute myocardial infarction (AMI). Methods Convenient selection the 90 patients with acute myocardial infarc-tion diagnosed by coronary angiography from January 2010 to June 2015 in our hospital , Compared with non AMI patients, Based on the presence of fQRS or pathological Q wave packet, the distribution characteristics and value of fQRS wave were analyzed. Results ①the probability of fQRS (12.22%) was higher than the anterior wall, lateral wall (5.6%), and(3.3%).②the sensitivity of simple pathological Q wave (25.56%) was slightly higher than that of simple fQRS wave (21.11%), but the pathological Q (69.70%and 88.89%) were lower than that of the fQRS (95.56%) and the positive predictive value (82.60%);When the combination of the two, the sensitivity and specificity, positive predictive value, negative predictive value (41.11%, 96.67%, 92.50%, 62.14%) were higher. ③In NSTEMI patients, the incidence of fQRS (38.10%) was significantly higher than that of pathological Q wave (14.29%), FQRS and fQRS combined with pathological Q wave was statistically sig-nificant (P<0.05). Conclusion FQRS wave has a certain diagnostic value for NSTEMI, which can be used as a new indica-tor for the diagnosis of acute myocardial infarction.