摘要
目的探讨碎裂QRS波(fragmented QRS complex,fQRS)对冠心病患者经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)后6个月内发生主要不良心血管事件(major adverse cardiovascular events,MACEs)的预测价值。方法回顾性纳入96例接受PCI的冠心病患者,术后随访6个月,根据是否发生MACEs分为MACEs组(24例)和非MACEs组(72例)。收集患者入院时的临床基线资料及心电图检查结果,比较两组间fQRS阳性率的差异。采用多因素Logistic回归分析探讨PCI术后6个月内发生MACEs的独立危险因素,并通过ROC曲线评估各因素对MACEs的预测效能。结果随访期间,MACEs发生率为25.00%(24/96)。MACEs组的低密度脂蛋白胆固醇(LDL-C)、总胆固醇水平及fQRS阳性率均显著高于非MACEs组,而左心室射血分数(LVEF)低于非MACEs组(均P<0.05)。多因素Logistic回归分析显示,LDL-C、总胆固醇、LVEF和fQRS均为PCI术后近期发生MACEs的独立危险因素(均P<0.05)。ROC曲线分析表明,fQRS预测MACEs的AUC值为0.813(95%CI 0.710~0.915),敏感性和特异性分别为83.33%和79.17%,预测价值高于LDL-C、总胆固醇和LVEF。结论fQRS是冠心病患者PCI术后6个月内发生MACEs的独立预测因素,对MACEs的发生具有一定的预测价值。
Objective To investigate the predictive value of fragmented QRS complex(fQRS)for the occurrence of major adverse cardiovascular events(MACEs)within 6 months after percutaneous coronary intervention(PCI)in patients with coronary heart disease.Methods A total of 96 patients with coronary heart disease who had undergone PCI were retrospectively enrolled.They were followed up for 6 months postoperatively,and divided into a MACEs group(24 cases)and a non-MACEs group(72 cases)based on the occurrence of MACEs.Clinical baseline data and electrocardiogram results on admission were collected,and the difference in the positive rate of fQRS between the two groups was compared.Multivariate Logistic regression analysis was used to explore independent risk factors for MACEs occurring shortly after PCI,while the predictive performance of each factor for MACEs was evaluated using ROC curves.Results During the follow-up,the incidence of MACEs was 25.00%(24/96).The levels of LDL-C,total cholesterol,and the positive rate of fQRS in the MACEs group were all significantly higher than those in the non-MACEs group,while LVEF was lower than that in the non-MACEs group(all P<0.05).Multivariate Logistic regression analysis showed that LDL-C,total cholesterol,LVEF,and fQRS were all independent risk factors for MACEs occurring shortly after PCI(all P<0.05).ROC curve analysis indicated that the AUC value of fQRS for predicting MACEs was 0.813(95%CI 0.710-0.915),with a sensitivity and specificity of 83.33%and 79.17%,respectively.Its predictive value was higher than that of LDL-C,total cholesterol,and LVEF.Conclusion The index of fQRS is an independent predictive factor for MACEs within 6 months after PCI in patients with coronary heart disease,and has certain predictive value.
作者
李超
刘永民
LI Chao;LIU Yongmin(Department of Cardiology,the Third People's Hospital of Anyang City,Anyang Henan 455001,China)
出处
《实用心电与临床诊疗》
2025年第6期843-848,共6页
PRACTICAL ELECTROCARDIOLOGY AND CLINICAL TREATMENT
关键词
冠心病
碎裂QRS波
经皮冠状动脉介入治疗
主要不良心血管事件
预测价值
coronary heart disease
fragmented QRS complex
percutaneous coronary intervention
major adverse cardiovascular event
predictive value
