中文概要
目的
探讨碎裂QRS 波(fQRS)联合心肌梗死溶栓治 疗临床试验(TIMI)危险评分对急性心肌梗死 (AMI)患者短期预后的评估价值。
创新点
TIMI 危险评分常用于AMI 患者入院即刻的风险 评估,TIMI 评分<4 分的患者被评定为中危组。 本研究发现,无论TIMI 评分如何,出现fQRS 而未行经皮冠状动脉介入治疗(PCI)的患者, 其死亡率均显著升高。fQRS 联合TIMI 危险评分 更利于AMI 患者的预后评估,TIMI 评分<4 分但 同时合并fQRS 的患者,可以从早期PCI 介入治 疗获益。
方法
回顾300例AMI患者的临床资料及院内诊治经过, 记录分析患者fQRS 出现的时间、部位及其他临 床转归,评价fQRS 联合TIMI 危险评分与患者临 床预后的关系。
结论
(1)fQRS 联合TIMI 危险评分可提高恶性心律 失常、左室收缩功能不全(LVSD)和死亡预测 的敏感度和特异度;(2)fQRS 阳性的AMI 患者, 进行早期血运重建可降低患者心血管事件发生 率,fQRS 可能作为TIMI 评分<4 分患者早期介入 治疗的指征。
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Project supported by the National Key Technology R&D Program of China (No. 2011BAI11B06)
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Sheng, Qh., Hsu, C.C., Li, Jp. et al. Combining fragmented QRS and TIMI score for predicting in-hospital short-term prognosis after acute myocardial infarction. J. Zhejiang Univ. Sci. B 19, 349–353 (2018). https://doi.org/10.1631/jzus.B1700413
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DOI: https://doi.org/10.1631/jzus.B1700413