| Background:Acute myocardial infarction(AMI)is the most severe type of coronary heart disease,Almost half of patients with myocardial infarction are dead before being hospitalized.Pathological Q waves were considered to be the marker ofa trans—mural MI,predictor of a poor prognosis,and increase the the short term and long term mortality.After performing of thrombolytic therapy and primary percutaneous coronary intervention,the mortality has been significantly decreased.Some of trans-mural MI in-patients with occlusive coronary arteries had recanalization which reduced the myocardial necrosis after re-perfusion therapy.At least two thirds of patients with prior myocardial infarction that had this treatment showed electrocardiograms with no pathological Q waves.There are some patients,over time,because of the recovering myocardium after the initial shock of the MI will gradually improve and the pathological Q wave will decrease or totally disappear.Fragmented QRS wave(fQRS wave)is a noninvasive electrocardiographic indicator.As a new kind of allelic Q wave,it has attracted much attention due to its cheapness,safety and convenience.It has been found that the fQRS wave on the surface of the body has an important value in the diagnosis and prognosis of myocardial infarction,and the frequency of fQRS wave is more frequent in patients with myocardial infarction than in unstable angina pectoris patients.Objective: Research and analysis of fractured surface electrocardiogram QRS wave detection rate with acute ST segment elevation myocardial infarction,the scope of ischemia and degree of correlation,provide a new prediction method.Methods: In this experiment in our hospital in October 2014-in October 2015,admitted during the period of 77 patients with acute ST segment elevation myocardial infarction as the study object.While 98 patients in the normal control group.With the admission results of coronary angiography and echocardiography in comparison to the fQRS wave in different scope and degree of coronary artery lesion,the detection rate of fQRS wave and aVR leads in the detection rate of multi-vessel lesions,PCI preoperative,postoperative fQRS wave had no change.Data are expressed as mean ± SD or n(%).Comparisons of continuous variables were performed using the unpaired t test.Comparisons of categorical variables were performed using the chi-square test.Result:Anterior descending branch,the right coronary artery and the left circumflex branch index in patients with a lesion of the fQRS detection rate were significantly higher than those without lesions of fQRS detection rate;From the different extent of coronary artery disease,compared to normal coronary artery and single vessel coronary disease,three branch lesions of the fQRS detection rate at the highest;From point of view of aVR lead indicators and multi vessel coronary artery disease patients fQRS detection rate of 69.39% was significantly higher than that of no coronary multivessel disease patients of fQRS wave detection rate is 3.57%.Conclusion:In the clinical diagnosis of acute ST segment elevation myocardial infarction(STEMI)reference electrogram fragmentation fQRS wave detection rate is of science and value,can through the index,determining the patients of actual prevalence and ischemia range and the subsequent clinical treatment has an important guiding significance.Early percutaneous coronary intervention(PCI),opened coronary artery,improve myocardial ischemia and reduce myocardial necrosis,and reduce the prevalence rate of ECG with fQRS.The positive rate of fQRS in preoperative,postoperative early PCI can improve myocardial ischemia and reduce the myocardial necrosis.The detection rate of fQRS in lead aVR of an ECG during the diagnosis of coronary multi—vessel disease has some predictive value. |
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