fQRS波对冠状动脉慢性完全闭塞患者侧枝循环分级及PCI术后心功能改善的预测价值
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(中国医科大学附属盛京医院,辽宁省沈阳市 110000)

作者简介:

杨天贵,硕士,主治医师,主要研究方向为冠心病及心律失常介入治疗,E-mail为yangtg1986@163.com。通信作者牛铁生,博士,主任医师,硕士研究生导师,主要研究方向为冠心病介入治疗、起搏器植入治疗、心脏瓣膜病介入治疗等,E-mail为niuts@sj-hospital.org。


Predictive value of fQRS in classification of collateral circulation and improvement of heart function after PCI in patients with chronic total occlusion
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Shengjing Hospital Affiliated to China Medical University, Shenyang, Liaoning 110000, China)

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    摘要:

    目的 观察冠状动脉慢性完全闭塞病变患者碎裂QRS波(fQRS)与冠状动脉侧枝循环分级及接受冠状动脉介入治疗(PCI)术后心功能改善情况的关系。方法 纳入2013年1月至2016年12月在中国医科大学盛京医院住院的冠状动脉完全闭塞病变患者245例,统计患者生物化学指标、心电图、介入手术资料、侧枝循环Rentrop分级、术前术后心功能指标。根据心电图有无碎裂QRS波分为碎裂QRS波组(fQRS组,n=108)和无碎裂QRS波组(nfQRS组,n=137),分析两组患者fQRS波与侧枝循环分级、PCI术后6个月及术后1年的心功能改善情况。结果 有fQRS波的患者侧枝循环等级比nfQRS组高,两组患者PCI术后左心室射血分数、6 min步行试验距离均有增加,左心室舒张末容积指数、脑钠肽均有下降,fQRS组与nfQRS组相比以上指标改变更加明显,且侧枝循环分级与心功能改善程度呈正相关。结论 冠状动脉慢性完全闭塞患者心电图出现fQRS波与侧枝循环分级呈正相关,冠状动脉介入治疗能够改善慢性完全闭塞患者的心功能,合并fQRS波的患者心功能改善更加明显。

    Abstract:

    Aim To investigate the relationship between fragmented QRS wave (fQRS) of the classification of coronary collateral circulation and the improvement of heart function after percutaneous coronary intervention (PCI) in patients with chronic total occlusion. Methods 245 cases of occlusion patients were included from January 2013 to December 2016 in Shengjing Hospital of China Medical University, to statistically analyse the biochemical indexes, electrocardiogram, interventional data, Rentrop classification of collateral circulation, preoperative and postoperative heart function. Patients were divided into fragmented QRS group (fQRS group, n=108) and no fragmentation of QRS group (nfQRS group, n=137) according to the state QRS wave in electrocardiogram, to analyse the difference of fQRS wave, classification of collateral circulation, and the improvement of heart function in 6 month and 1 year after the operation in the two groups. Results The level of collateral circulation in patients of fQRS wave was higher than the nfQRS group, the ventricular ejection fraction and 6 minutes walk test distance were increased after PCI treatment in the two groups of patients, but the left ventricular end diastolic volume index and the brain natriuretic peptide were decreased, the above index change more significantly in fQRS group compared to nfQRS group, the difference was statistically significant, and the collateral circulation classification and the improvement of heart function were positively correlated. Conclusion In coronary chronic total occlusion patients, fQRS was positively related to classification of collateral circulation, percutaneous coronary interventional therapy can improve heart function in patients with chronic total occlusion, and the heart function in patients with fQRS were improved obviously.

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杨天贵,付鹏,陈洁,牛铁生. fQRS波对冠状动脉慢性完全闭塞患者侧枝循环分级及PCI术后心功能改善的预测价值[J].中国动脉硬化杂志,2018,26(10):1031~1036.

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  • 收稿日期:2018-03-09
  • 最后修改日期:2018-03-18
  • 在线发布日期: 2018-11-09