心电图碎裂QRS波在急性心肌梗死诊断中价值.docVIP

心电图碎裂QRS波在急性心肌梗死诊断中价值 　　【摘要】 目的 探讨心电图碎裂QRS波在急性心肌梗死诊断中的价值。方法 收集急性心肌梗死患者作为本次研究对象， 按患者是否出现ST段抬高分为50例ST段抬高型急性心肌梗死组和50例非ST段抬高型急性心肌梗死组。对比①ST段抬高型急性心肌梗死组中病理性Q波及碎裂QRS波发生比例；②非ST段抬高型急性心肌梗死组中病理性Q波及碎裂QRS波发生比例。结果 ①ST段抬高型急性心肌梗死组中病理性Q波及碎裂QRS波发生比例分别为60%、12%， 差异有统计学意义（P0.05）；②非ST段抬高型急性心肌梗死组中病理性Q波及碎裂QRS波发生比例分别为14%、60%， 差异有统计学意义（P0.05）。结论 本次研究认为碎裂QRS波对诊断急性心肌梗死， 特别是非ST段抬高型急性心肌梗死有较高的诊断价值。 　　【关键词】 心电图；碎裂QRS波；急性心肌梗死 　　DOI：10.14163/j.cnki.11-5547/r.2015.25.016 　　【Abstract】 Objective To investigate value of electrocardiogram fragmented QRS complexes in diagnosis of acute myocardial infarction. Methods Patients with acute myocardial infarction were collected as study subjects. They were divided by occurrence of ST segment elevation into ST segment elevation acute myocardial infarction group with 50 cases and non-ST segment elevation acute myocardial infarction group with 50 cases. Comparisons were made on ① proportion of pathological Q wave and fragmented QRS complexes in ST segment elevation acute myocardial infarction group； ② proportion of pathological Q wave and fragmented QRS complexes in non-ST segment elevation acute myocardial infarction group. Results ① Proportion of pathological Q wave and fragmented QRS complexes were respectively 60% and 12% in ST segment elevation acute myocardial infarction group. The difference had statistical significance （P0.05）. ②Proportion of pathological Q wave and fragmented QRS complexes were respectively 14% and 60% in non-ST segment elevation acute myocardial infarction group. The difference had statistical significance （P0.05）. Conclusion This study shows fragmented QRS complexes’ high value for diagnosis of acute myocardial infarction， especially for non-ST segment elevation acute myocardial infarction. 　　【Key words】 Electrocardiogram； Fragmented QRS complexes； Acute myocardial infarction 　　急性心肌梗死是冠状动脉急性、持续性缺血缺氧所引起的心肌坏死， 临床上多有剧烈而持久的胸骨后疼痛， 休息及硝酸酯类药物不能完全缓解， 伴有血清心肌酶活性增高及进行性心电图变化[1]。随着介入， 早期溶栓等治疗手段的出现， 使得Q波型心肌梗死发生率明显下降。非Q波型和非ST段急性心肌梗死出现率明显增加。本文选取2