碎裂QRS波在心肌梗死中的研究

近年来,由于溶栓、冠脉介入等早期治疗的广泛应用,Q波型心肌梗死的发生率明显下降。同时,随着时间的推移,部分患者Q波的时间、振幅逐渐减小甚至消失,使非Q波型心肌梗死(non-Q-wave myocardial infarction,NQMI)和非ST段抬高型心肌梗死(non-ST-segment elevation myocardial infarction,NSTEMI)的发生率明显升高。但是这两种心肌梗死在心电图上无特征性改变,早期容易漏诊,所以需要寻找其他新的特异性指标。碎裂QRS波(fragmented QRS complex,fQRS)是新的心电学指标,它对心肌梗死有较确切的诊断和预测价值。本文就fQRS的形成机制及其在心肌梗死方面的作用展开阐述。

The research of fragmented QRS complex in patients with myocardial infarction

In recent years,due to the widespread application of early therapies such as thrombolysis and percutaneous coronary intervention,the incidence of Q-wave myocardial infarction significantly decreases. Meanwhile,the duration and amplitude of Q waves will gradually decrease or even disappear over time,which significantly increases the incidences of non-Q-wave myocardial infarction(NQMI) and non-ST-segment elevation myocardial infarction(NSTEMI). However,neither NQMI nor NSTEMI has characteristic changes on 12-lead electrocardiogram. For this reason,both of them are prone to be missed clinically and thus other new specific indexes are needed. Fragmented QRS complex(fQRS) is a new indicator which shows high sensitivity and specificity in identifying and predicting myocardial infarction. In this paper,we will elaborate the mechanism of fQRS and the role it plays in the diagnosis of myocardial infarction.