摘要
目的探讨空间QRS⁃T夹角与冠状动脉病变的关系及对经皮冠状动脉介入术(PCI)后主要不良心脏事件(MACE)的预测价值。方法选择在我院就诊的180例冠心病患者设为观察组,85例非冠心病患者设为对照组,行立体心电图检查,记录空间QRS⁃T夹角。Gensini积分法评估冠脉狭窄程度,分为轻度亚组、中度亚组、重度亚组。观察组174例行PCI手术患者随访6个月。分析对照组、观察组空间QRS⁃T夹角大小及构成比;分析PCI术后患者空间QRS⁃T夹角与MACE发生的关系。结果观察组空间QRS⁃T夹角大于对照组[(91.86±45.67)°vs.(50.83±40.58)°,P<0.05]。空间QRS⁃T夹角>100°在重度亚组占比高于轻度、中度亚组(76.9%vs.39.7%,76.9%vs.42.3%)。采用logistic多因素回归分析,空间QRS⁃T夹角>100°(OR=3.096,95%CI:1.106~8.671,P<0.05)是PCI术后发生MACE的危险因素。空间QRS⁃T夹角>100°诊断重度亚组敏感性为76.9%,特异性为59.1%,ROC曲线下面积为0.680(95%CI:0.600~0.761,P<0.05);预测PCI术后MACE发生的敏感性为70.5%,特异性为52%,ROC曲线下面积为0.612(95%CI:0.517~0.708,P=0.027)。结论空间QRS⁃T夹角>100°在初步评估冠心病冠状动脉狭窄程度及预测PCI术后MACE的发生有一定的临床价值。
Objective To investigate the relationship between QRS⁃T angle and coronary artery disease(CHD)and its predictive value for MACE after PCI.Methods 180 patients with CHD admitted to our hospital were selected as the case group,and 85 non⁃CHD were selected as the control group.All patients underwent the three⁃dimensional electrocardiogram to measure spatial QRS⁃T angle.According to the Gensini score,the case group were divided into three group,mild subgroup,moderate subgroup and severe subgroup.174 patients who un⁃derwent PCI were followed up for 6 months.The spatial QRS⁃T angle and composition ratio between groups were compared and analyzed.Explore the relationship between spatial QRS⁃T angle and MACE in patients after PCI.Results The Spatial QRS⁃T angle of the case group was larger than the control group[(91.86±45.67)°vs.(50.83±40.58)°,P<0.05].The ratio of QRS⁃T angle>100°in the severe subgroup was higher than that in the mild subgroup(76.9%vs.39.7%)and moderate subgroup(76.9%vs.42.3%).Logistic regression analysis results showed that,QRS⁃T angle>100°is a risk factor for MACE in patients with CHD after PCI(OR=3.096,95%CI:1.106~8.671,P<0.05).The sensitivity and specificity of the QRS⁃T angle>100°on the diagnosis of the severe subgroup with CHD were 76.9%and 59.1%,the area under ROC curve was 0.680(95%CI:0.600~0.761,P<0.05).The sensitivity and specificity of the QRS⁃T angle>100°on prediction MACE was 70.5%and 52%,the area under ROC curve was 0.612(95%CI:0.517~0.708,P=0.027).Conclusions QRS⁃T angle>100°has certain clinical value on preliminary assessment of the degree of coronary stenosis,and on prediction MACE after PCI.
作者
黄静和
陈思敏
许研
冷丽丽
陈柏蓉
HUANG Jinghe;CHEN Simin;XU Yan;LENG Lili;CHEN Borong(Department of Ultrasound Electrocardio-graphic Room,Guangdong Second Provincial General Hospital,Guangzhou 510317,China)
出处
《实用医学杂志》
CAS
北大核心
2020年第22期3130-3134,共5页
The Journal of Practical Medicine
基金
广东省医学科学技术研究基金项目(编号:A2019132)。
