碎裂QRS波在冠心病心肌缺血诊断中应用技术分析.docVIP

碎裂QRS波在冠心病心肌缺血诊断中应用技术分析 　[摘要] 目的 探讨碎裂QRS波在冠心病心肌缺血诊断中的应用价值。 方法 收集经冠状动脉造影诊断为冠心病心肌缺血的患者100例作为冠心病组，对照组选取同期行冠状动脉造影无冠状动脉病变证据者100例，比较两组心电图碎裂QRS波的发生率并分析其在心电图相对应的心肌前壁、下壁和侧壁导联的分布情况；按碎裂QRS波在心电图中出现与否将冠心病组分为碎裂QRS波阳性组和阴性组，观察碎裂QRS波在左前降支（LAD）病变、左回旋支（LCX）病变和右冠状动脉（RCA）病变中的发生率。 结果 冠心病组碎裂QRS波的发生率明显高于对照组，冠心病组下壁导联碎裂QRS波的发生率显著高于对照组，差异均有统计学意义（Plt;0.01），两组前壁和侧壁导联碎裂QRS波的发生率比较差异无统计学意义（Pgt;0.05）；碎裂QRS波阳性组LCX病变的发生率高于碎裂QRS波阴性组，差异有统计学意义（Plt;0.05），碎裂QRS波阳性组LAD病变、RCA病变的发生率与碎裂QRS波阴性组比较，差异均无统计学意义（Pgt;0.05）。 结论 心电图中碎裂QRS波对冠心病心肌缺血有一定的预测价值，尤其是下壁导联出现碎裂QRS波提示冠心病心肌缺血的可能性大，碎裂QRS波对LCX病变的预测价值较高。 　[关键词] 体表心电图；碎裂QRS波；冠状动脉造影；冠心病心肌缺血 　[中图分类号] R540.4+1 [文献标识码] A [文章编号] 1674-4721（2014）11（c）-0043-03 　[Abstract] Objective To discuss the application value of fragmented QRS wave in the diagnosis of myocardial ischemia of coronary artery disease. Methods 100 patients with myocardial ischemia of coronary heart disease diagnosed by coronary angiography were collected as the coronary artery disease group，100 cases without evidence of coronary artery disease lesion confirmed by coronary angiography were selected in the same period as the control group.The incidence rate of fragmented QRS wave in electrocardiogram （ECG） and the distribution of anterior wall，inferior wall and lateral wall myocardial lead corresponding in ECG was analyzed in the two groups；the coronary artery disease group was divided into the the positive group of fragmented QRS wave and the negative group of fragmented QRS wave according to whether the emergence of fragmented QRS the left anterior descending （LAD），left circumflex （LCX） and right coronary artery （RCA） were observed. Results The incidence rate of the fragmented QRS wave in the coronary artery disease group was obviously higher than that in the control group，the incidence rate of fragmented QRS wave in the inferior wall lead of the coronary artery disease group was obviously higher than that in the control group，and there was a statistical difference （Plt;0.01），there was no statistical diffe