超声心动图联合心电图QRS碎裂波诊断心肌梗死的效果分析

目的 :探讨分析超声心动图联合心电图QRS碎裂波(fQRS)在心肌梗死诊断价值及其临床效果观察.方法 :选取2014年6月~2016年6月我院收治的128例心肌梗死患者,根据超声心动图联合心电图QRS破碎波检查分为3组,其中A组46例,无fQRS波,左心室射血分数(Left ventricular ejection fractions,LVEF)正常;B组37例,患者伴fQRS波,LVEF正常;C组45例,伴fQRS波,LVEF<50%.比较分析3组患者的冠状造影结果以及室性心律失常的情况.结果 :C组患者的多支病变的发生率为91.11%,显著高于A组的41.30%和B组的78.38%,比较差异具有统计学意义;C组患者的完全性闭塞发生率为48.89%,显著高于A组的8.70%和B组的16.22%,比较差异具有统计学意义.A组患者的Lown分级 Ⅰ 级、Ⅱ级分别为9例(19.57%)、21例(45.65%),B组的Lown分级 Ⅰ 级、Ⅱ级分别为4例(10.81%)、8(21.62%),C组的Lown分级 Ⅰ 级、Ⅱ 级分别为0例(0)、2例(4.44%).C组患者Lown分级Ⅲ 级以上43例(95.56%),显著高于A组的16例(34.78%)和B组的25例(67.57%),比较差异具有统计学意义.结论 :伴fQRS波且LVEF下降患者的冠状动脉多支病变、完全性闭塞,以及严重室性心律失常的发生率极高,超声心动图联合fQRS在心肌梗死的诊断中效果显著,具有显著的预警价值.

Clinic effect of echocardiogram combined with electrocardiogram QRS on diagnosis ofmyocardial infarction

Objective To investigate the clinic effect of echocardiogram combined with electrocardiogram QRS on diagnosis ofmyocardial infarction. Methods One hundred and twenty-eight patients with myocardial infarction admitted into our hospi-tal from June 2014 to June 2016 were divided into three groups that no fQRS with normal LVEF of 46 cases were as group A, fQRS with normal LVEF of 37 cases were as group B, and fQRS with decreased LVEF of 45 cases were as group C according to the shape ofQRS and echocardiography. The results of coronary angiography and ventricular arrhythmias of three groups were analyzed and compared. Results The detection rate of multivessle coronary lesions in group C was 91.11%, which was much higher than that of group A with 41.30% and group B with 78.38%, respectively. And incidence rate of complete occlusion in group C was 48.89%, which was much higher than that of group A with 8.70% and group B with 16.22%, respectively. Addi-tionally, the total number (incidence rate) of patients with grade Ⅰand Ⅱ of Lown's scales in group A, group B and group C were 9(19.57%) and 22(45.65%), 4(10.81%) and 8(21.62%), and 0(0) and 2(4.44%), respectively. The total number (incidence rate) of patients with Lown's scales above grade Ⅲ in group C was 43(95.56%), which was significantly higher than that of group A with 16(34.78%) and group B with 25(67.57%), respectively. Conclusion The patients with myocardial infarction showed much higher incidence rate of severe ventriculararrhythmia, multivessel coronary lesions, and complete occlusion. And echocardio-gram combined with electrocardiogram QRS had a great capability on diagnosis and predicting high risk ofmyocardial infarction.