摘要
目的探讨急性心肌梗死(AMI)患者碎裂QRS(fQRS)波与自主神经功能及左室重构的相关性。方法选取2015年1月至2021年6月武警北京总队医院收治的114例AMI患者,根据是否存在fQRS分为fQRS组(51例)和无fQRS组(63例)。比较两组一般资料、心率变异性参数和左室功能指标,分析fQRS与心率变异性参数和左室功能指标的相关性。结果fQRS组ST段抬高型心肌梗死比例、总胆固醇、低密度脂蛋白胆固醇、血肌酐、血尿素氮、血尿酸、心肌肌钙蛋白I、肌酸磷酸激酶、肌酸激酶同工酶、室间隔厚度(IVST)、左室后壁厚度(LVPW)高于无fQRS组,高密度脂蛋白胆固醇、低频谱功率、极低频谱功率、低频谱与高频谱功率比值(LF/HF)、24 h正常窦性R-R间期标准差(SDNN)、24 h内每5分钟窦性R-R间期均值标准差(SDANN)、左心室射血分数(LVEF)低于无fQRS组,差异有统计学意义(P<0.05)。fQRS与低频谱功率、极低频谱功率、LF/HF、SDNN、SDANN、LVEF呈负相关(r=-0.364、-0.409、-0.365、-0.428、-0.355、-0.423,P<0.001),与IVST、LVPW呈正相关(r=0.457、0.544,P<0.001)。fQRS与高频谱功率无相关性(r=-0.141,P>0.05)。结论存在fQRS的AMI患者心脏自主神经功能障碍明显,与左室重构密切相关。
Objective To investigate the correlation between fragmented QRS(fQRS)waves and autonomic function and left ventricular remodeling in patients with acute myocardial infarction(AMI).Methods A total of 114 patients with AMI admitted to Hospital of Beijing Armed Police Corps from January 2015 to June 2021 were selected and they were divided into fQRS group(51 cesea)and non-fQRS group(63 cases)according to the presence or absence of fQRS.The baseline data,heart rate variability parameters,and left ventricular function indexes were compared between the two groups,and the correlation of fQRS with heart rate variability parameters and left ventricular function indexes were analyzed.Results The proportion of ST-segment elevation myocardial infarction,total cholesterol,low density lipoprotein cholesterol,serum creatinine,blood urea nitrogen,blood uric acid,cardiac troponin I,creatine phosphokinase,creatine kinase isozyme,ventricular septal thickness(IVST),and left ventricular posterior wall thickness(LVPW)in fQRS group were higher than those in non-fQRS group.High density lipoprotein cholesterol,low spectral power,very low spectral power,low spectral power to high spectral power ratio(LF/HF),standard deviation of 24 h normal sinus R-R interval(SDNN),mean deviation of every five minutes sinus R-R interval(SDANN),and left ventricular ejection fraction(LVEF)were lower than those in the non-fQRS group,the differences were statistically significant(P<0.05).fQRS was negatively correlated with low spectral power,very low spectral power,LF/HF,SDNN,SDANN and LVEF(r=-0.364,-0.409,-0.365,-0.428,-0.355,-0.423,P<0.001),it was positively correlated with IVST and LVPW(r=0.457,0.544,P<0.001).FQRS had no correlation with high spectral power(r=-0.141,P>0.05).Conclusions Cardiac autonomic dysfunction is evident in AMI patients with fQRS and is closely associated with left ventricular remodelling.
作者
胡艳丽
单青
肖洒
韩玉华
HU Yanli;SHAN Qing;XIAO Sa;HAN Yuhua(The Second Department of Intermal Medicine,Hospital of Beijing Armed Police Corps,Beijing 100027,China;the Third Department of Intermal Medicine,Hospital of Beijing Armed Police Corps,Beijing 100027,China)
出处
《中国医药导报》
CAS
2022年第23期53-56,78,共5页
China Medical Herald
基金
首都卫生发展科研专项项目(首发2018-3-4120)。
关键词
急性心肌梗死
碎裂QRS波
自主神经功能
左室重构
Acute myocardial infarction
Fragmented QRS waves
Autonomic function
Left ventricular remodeling
