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V2V3导联碎裂QRS波对冠心病的预测价值 被引量:6

Diagnostic significance to the coronary artery disease with fragmented QRS wave in precordial leads V2 or V3
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摘要 目的:探讨V2V3导联碎裂QRS对冠心病的预测价值。方法:回顾性分析680例患者冠脉造影的结果,并与冠脉造影前常规心电图检查结果进行对比分析,多因素Logistic回归分析影响冠心病和左前降支狭窄独立的预测因素。结果:640例患者中,Q(+)组74例(11.6%),Q(-)组566例(88.4%)。冠脉造影发现355例(55.5%)至少一支冠脉狭窄,其中Q(+)组58例(78.4%),Q(-)组297例(52.5%),Q(+)组冠脉狭窄发生率明显高于Q(-)组(P<0.001)。经多因素Logistic回归分析显示:QRS波起始有Q波(OR=2.454,95%CI1.061~5.681,P<0.001)、年龄>65岁(OR=1.109,95%CI1.086~1.133,P<0.001)和男性(OR=1.574,95%CI1.010~2.432,P<0.05)是冠心病和左前降支狭窄独立的预测因素。结论:V2或V3导联QRS波起始有Q波,伴或不伴Q波切迹对冠心病有独立预测价值,尤其对左前降支狭窄有预测价值。 Objective To evaluate the clinical prediction efficiency for coronary artery disease with the fragmented QRS complex in leads V2 or V3. Methods ECG of 680 consecutive patients was retrospective analyzed after and front coronary angiography. Multiple logistic regression model was used for the analysis of sensitive independent predictor about coronary artery disease (CAD) and left anterior descending artery (LAD). Results In 640 patients, the Q (+) group 74 ( 11.6% ), Q (-) group 566 (88.4%). CAD 355 (55.5%) patients at least one coronary artery stenosis, the number of patients with significant coronary stenosis was 58 (78.4% ) Q ( + ) group and 297 ( 52.5% ) Q (-) group(P 〈 0.001 ). Multiple logistic regression analysis revealed: the significant independent predictors in the diagnosis of CAD or LAD stenosis, such as presence of Q wave(OR = 2.454, 95%CI 1.061 - 5.681, P 〈 0.001), age (〉 65years) (OR = 1.109, 95%C1 1.086- 1.133, P〈 0.001), male sex(OR = 1.574, 95%CI 1,010-2.432, P〈 0.05). Conclusion The QRS wave in V2 or V3 with or without early fragmentation could be significantly predicted presence of CAD, especially significant in stenosis of the LAD.
出处 《实用医学杂志》 CAS 北大核心 2011年第23期4218-4220,共3页 The Journal of Practical Medicine
关键词 冠心病 心电图 冠脉造影 Coronary disease Electrocardiogram Coronary angiography
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参考文献10

  • 1朱俏萍,刘伊丽,李穗鸥,郑少玲,肖阳娥,郑燕列,黄建华,郭军,聂晨阳,李丽娜.冠心病患者自主神经功能失衡防治的临床探讨[J].现代医院,2011,11(4):12-15. 被引量:1
  • 2邝鸿生,林宇鹏,谢阳,林锐,陈扬波.外周动脉疾病相关危险因素的临床分析[J].现代医院,2011,11(3):30-32. 被引量:4
  • 3Das M K, Khan B, Jacob S, et al. Significance of fragmented QRS complex versus a Q wave in patients with coronary artery disease [J]. Circulation, 2006, 113(21):2495-2501.
  • 4郭继鸿.碎裂QRS波[J].临床心电学杂志,2008,17(1):60-68. 被引量:159
  • 5王时森.经典心脏病学[M].北京:人民军医出版社,2007:170.
  • 6Bogaty P, Boyer L, Rousseau L, et al. Is anteroseptal myocardial infarction an appropriate term [J]? Am J Med, 2002,113(1) :37-41.
  • 7赵国声,曾秋棠.心电图前间壁心肌梗死室壁运动异常部位及冠状动脉闭塞位置分析[J].当代医学,2008,14(8):82-85. 被引量:1
  • 8郭继鸿.心电图学[M].北京:人民卫生出版社,2005:1030.
  • 9Surawicz B, Knilans T K. Myocardial infarction and electrocardiographic patterns simulating myocardial infarction [M]//Surswicz B, Knilans T K. Chou's electrocardiography in clinical practice. 6th ed. Saunders- Philadelphia, 2005: 162.
  • 10Thygesen K, Alpert J S, White H D, et al. Universal definition of myocardial infarction [J]. Circulation, 2007,116 (22) : 2634-2653.

二级参考文献20

  • 1SCHMIDT G,MALIK M,BARTHEL P,et al.Heart-rate turbulence after ventricular premature beats as a predictor of mortality after acute mycardial infarction[J].Lancet,1999,353(8 228):1390-1396.
  • 2PUMPRLA J,HOWORKA K,GROVES D,et al.Functional assess ment of heart rate variability:physiological basis and pratical applications[J].Int J Cardiol,2002,84(1):1.
  • 3GHURAN A,REID F,LA ROVERE M T,et al.Heart rate turbulence based predictors of fatal and nonfatal cardiac arrest.The autonomic tone and reflexes after myocardial infarction substudy[J].Am J Cardiol,2002,89(11):187-190.
  • 4GAO F,GAO E,YUE T L,et al.Nitric oxide mediates the antiapoptotic effect of insulin in myocardial ischemia reperfution:the roles of P13-Kinase,Akt,and endothelialnitric oxide synthase phosphorylation[J].Cireulation,2002,105:1497.
  • 5ALLEN LAPOINTE N M,ZHOU Y,STAFFORD J A,et al.Association between mor-tality and persistent use of beta blockers and angiotensin-converting enzyme inhibitors in patients with left ventricular systolic dysfunction and coronary artery disease[J].Am J Cardiol,2009,103(11):1518-1524.
  • 6MAKIN A, LIP G Y, SILVERMAN S, et al. Peripheral vascular disease and hypertension : a forgotten association ? [ J]. Hum Hypertension, 2001,15,447 - 454.
  • 7CRIQUI M H,DENENBERG J O,LANGER R D,et al. The epidemiology of peripheral arterial disease:importance of identifying the population at risk. [ J]. Vasc Med, 1997,2:221 - 226.
  • 8HIATT W R, HIRSCH A T, REGENSTEINER J G, et al. Clinical trials for claudication. Assessment of exercise performance, fune- tional status,and clinical end points. [ J]. Circulation,1995,92: 614 -621.
  • 9Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of.high blood cholesterol in adults( adult treatment panel Ⅲ ) [J]. JAMA,2001,285:2486 -2497.
  • 10The American College of Cardiology foundation and the American Heart Association. ACC/ AHA guidelines for the management of patients with peripheral arterial disease[ S] ,2005.

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