Page 23 - 2020年8月第3期总39期_Neat

SOCIAL FOCUS
基础研究
社会焦点 FUNDAMENTAL RESEARCH 振东学术·ZHENDONG SCIENCE

碎裂QRSQRS波与急性冠脉综合征患者冠脉病变波与急性冠脉综合征患者冠脉病变
碎裂
及短期预后的相关性研究
及短期预后的相关性研究
刘欢，高敏，王延林，王慕秋，狄欣欣
（安徽医科大学附属省立医院、安徽省立医院心血管内科，合肥 230001）
【摘要】目的：探讨碎裂 QRS 波（fQRS）与急性冠脉综合征（ACS）患者冠脉病变、短期内不良心血管事件间
的相关性。方法：回顾性分析 361 例 ACS 患者的实验室检查、心电图、冠脉造影结果等临床资料，并借助
Gensini评分、SYNTAX评分定量评估冠脉病变严重程度。根据心电图上是否存在fQRS，分为fQRS（+）和
fQRS（-）组，出院后均随访6个月，记录主要不良心血管事件（MACE）的发生情况。比较两组在冠脉病变、

MACE 的发生上是否存在差异，并寻找影响ACS患者短期预后的危险因素。结果：共142例在心电图出现
fQRS，其检出率为 39.3%（142/361），STEMI、NSTEMI 患者的 fQRS 检出率明显高于 UA 患者（P<0.05）。与
fQRS（-）组相比，fQRS（+）组患者三支病变多见，Gensini评分、SYNTAX 评分更高，6个月内MACE发生率
更高（48.5% 比 13.2%，P<0.05），且以非计划再次血运重建、心力衰竭及再发心绞痛事件为主。多因素
logistic 回归分析发现 fQRS、Gensini 评分、SYNTAX 评分是影响 ACS 患者短期预后的独立危险因素。结

论：ACS 患者心电图上出现 fQRS 能够反映出冠脉病变的严重程度，且可以作为短期预后的独立预测
指标。
【关键词】冠状动脉粥样硬化；心电描记术；心血管生理学现象；预后

Correlation
Correlation between the fragmentedQRScomplex and coronary artery lesions andbetween the fragmentedQRScomplex and coronary artery lesions and
shorttermprognosis
shorttermprognosis in patients with acute coronary syndromein patients with acute coronary syndrome
Liu Huan, Gao Min,Wang Yanlin, Wang Muqiu, Di Xinxin
(Department of Cardiology, Anhui Provincial Hospital,Hefei 230001, China)
[Abstract]
[Abstract] ObjectiveObjective:To investigate the correlation between fragmented QRS complex (fQRS) and coronary artery le-
sions and short-term adverse cardiovascular events in patients with acute coronary syndrome (ACS).Methods:Methods:The

clinical data of 361 ACS patients with laboratory examination,electrocardiogram,and coronary angiography were ret-
rospectively analyzed,and the severity of coronary lesions was quantitatively evaluated by the Gensini score and
SYNTAX score.They were divided into fQRS(+) group and fQRS (-) group according to the presence or absence of
fQRS on the electrocardiogram.They were followed up for 6 months after discharge,and the major adverse cardiovas-

cular events (MACE) were recorded.Compare the difference between the two groups in the occurrence of coronary
artery disease and MACE,and look for the risk factors that affect the shortterm prognosis of patients with ACS.ReRe--
sults:Among a total of 142 patients,the detection rate of fQRS on ECG was 39.3% (142/361).The fQRS detection rate
sults:
in STEMI and NSTEMI patients was significantly higher than that of UA patients(P<0.05).Compared with the fQRS

(-)group,the threevessel disease was more common in the fQRS(+)group,with higher Gensini score and SYNTAX
score,and a higher incidence of MACE within 6 months (48.5% vs 13.2%,P<0.05).Unplanned revascularization,
heart failure,and recurrence of angina were the main causes.Multivariate logistic regression analysis found fQRS,

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