Poincare散点图联合心电图QRS碎裂波诊断心肌梗死的临床研究

目的 观察Poincare散点图联合心电图QRS碎裂波（fQRS）在心肌梗死诊断中的应用价值。方法 选择我院2015年1月~2017年5月确诊为心肌梗死的患者84例,其中急性心肌梗死（AMI）患者44例;陈旧性心肌梗死（OMI）患者40例。根据十二导联心电图QRS波形态分为fQRS波组（56例）及无fQRS波组（28例）,其中fQRS波组患者根据Poincare散点图形状分为非彗星状组（A组）和彗星状组（B组）,无fQRS波组（C组）。均以冠状动脉造影术诊断结果为诊断“金标准”,分析各组冠状动脉造影结果,进行组间比较。结果 冠状动脉造影结果显示：A组冠状动脉单支病变2例（6.7%）,多支病变28例（93.3%）;B 组冠状动脉单支病变5例（19.23%）,多支病变21例（80.77%）;C组冠状动脉单支病变18例（64.29%）,多支病变12例（42.86%）,其中B、C组多支病变百分比较A 组小,差异有统计学意义,P＜0.05。A组中的完全闭塞发生率（56.67%）显著高于B组（19.23%）,C组（21.43%）,差异均有统计学意义,P＜0.05。结论 Poincare散点图联合心电图QRS碎裂波形检查在诊断急性心肌梗死伴冠状动脉完全闭塞发生率明显高于Poincare散点图正常合并fQRS波形及无fQRS波形,两项指标联合应用对高危心肌梗死预警有一定临床意义。

Clinical Study on the Diagnosis of Myocardial Infarction by Poincare Scatter Pattern Combined with ECG QRS Fragmentation

Objective To observe the value of Poincare scatter plot combined with electrocardiogram QRS cleavage (fQRS) in the diagnosis of myocardial infarction. Methods Forty-eight patients with acute myocardial infarction (AMI) were enrolled in our hospital from January 2015 to May 2017, 40 patients with acute myocardial infarction (OMI). (68 cases) and no fQRS wave group (16 cases). The patients in the fQRS group were divided into non-comet group (group A) according to the Poincare scatter plot, And comet - like group (group B), no fQRS group (group C). Coronary angiography was used to diagnose the "gold standard", the results of coronary angiography were analyzed and compared between groups. Results:Coronary angiography showed that there were 2 cases (6.7%) of single coronary artery disease in group A, 28 cases (93.3%) in multivessel disease, 5 cases (19.23%) with single coronary artery disease in group B, (64.77%). There were 18 cases (64.29%) of single coronary artery disease in group C and 12 cases (42.86%) of multivessel disease. The percentage of group B and group C was smaller than that of group A, the difference was statistically significant, P <0.05. The incidence of complete occlusion in group A (56.67%) was significantly higher than that in group B (19.23%), group C (21.43%), the difference was statistically significant (P <0.05). Conclusion The incidence of complete occlusion of acute myocardial infarction with coronary artery was significantly higher than that of Poincare scatter plots. The fQRS waveforms and fQRS waveforms were not combined with Poincare scatterplot combined with electrocardiogram. The two indexes were combined with high risk myocardial infarction Early warning has a certain clinical significance.