碎裂QRS波诊断陈旧性心肌梗死的价值分析

目的：探讨心电图中碎裂QRS波（ fQRS波）诊断陈旧性心肌梗死的价值。方法选取136例符合陈旧性心肌梗死的患者为研究对象，根据心电图中有无fQRS波分为fQRS波组（ n＝92）与无fQRS波组（ n＝44），比较两组间冠状动脉狭窄数量以及频发室性早搏、室性心动过速、病理性 Q波、室壁运动异常和左室射血分数（ LVEF）≤40%的发生率。结果136例患者中fQRS波92例，占67.7%；病理性Q波65例，占47.8%。fQRS组冠状动脉狭窄2支或3支数量明显多于无fQRS组，而无fQRS组单支病变多于fQRS组，差异有统计学意义（χ^2＝23.802，P〈0.01）；fQRS组频发室性早搏、室性心动过速及室壁运动异常例数均明显多于无fQRS组，且左室射血分数≤40%的例数明显多于 fQRS 组，差异均有统计学意义（分别为58.7% vs 36.4%，χ^2＝5.943，P ＝0.015；60.9% vs 36.4%，χ^2＝23.416，P＝0.000；67.4% vs 43.2%，χ^2＝7.243，P＝0.007；68.5% vs 50.0%，χ^2＝4.336， P＝0.037）；而两组间病理性Q波例数比较差异无统计学意义（48.9% vs 45.5%，χ^2＝1.586，P＝0.208）。结论fQRS波可作为诊断陈旧性心肌梗死的一个新指标。

Value of fragmented QRS complex on diagnosis of old myocardial infarction

Objective To investigate the clinical value of fragmented QRS complex（ fQRS ）on the diagnosis of old ocardial infarction（ OMI ）. Methods One hundred and thirty-six patients＆amp;nbsp;with OMI were divided into group with fQRS（ n=92 ）and group without fQRS（ n=44 ）according to the electrocardiogram expression. The number of coronary artery stenosis and the incidences of frequent pre-mature ventricular beat,ventricular tachycardia,pathologic Q wave,ventricular wall motion abnormali-ties and left ventricular ejection fraction（ LVEF）≤40% were compared between the two groups. Results Among the 136 cases,92 patients with fQRS（ 67. 7%） and 65 patients with pathologic Q wave （47. 8%）. The incidences of coronary artery stenosis in 2 or 3 branches of group with fQRS were more than those of group without fQRS obviously,while incidences of single lesion of the group without fQRS were more than those of group with fQRS（χ^2 =23. 802 ,P〈0. 01 ）. The number of coronary artery steno-sis and frequent premature ventricular beat,ventricular tachycardia,the incidence of ventricular wall mo-tion abnormalities and left ventricular ejection fraction（ LVEF）≤40% of the fQRS group were signifi-cantly more than those of the group without fQRS（ respectively were 58. 7% vs 36. 4%,χ^2 =5. 943 ,P=0. 015;60. 9% vs 36. 4%,χ^2 =23. 416 ,P=0. 000;67. 4% vs 43. 2%,χ^2 =7. 243 ,P=0. 007;68. 5%vs 50. 0%,χ^2 =4. 336 ,P=0. 037 ）,while there were no significant differences in pathologic Q wave between the two groups（ 48. 9% vs 45. 5%,χ^2 =1. 586 ,P =0. 208 ）. Conclusions FQRS wave can be used as a new index for the diagnosis of old myocardial infarction.