心电图QTc及相关指标对非ST段抬高型心肌梗死患者预后的评估价值
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陕西省科学技术研究发展计划项目(2018K25313);


Prognostic value of QTc in electrocardiogram and related indicators in pa-tients with non-ST-segment elevation myocardial infarction
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    摘要:

    目的:探讨心电图QTc及相关指标对非ST段抬高型心肌梗死(NSTEMI)患者预后的评估价值。方法:选取106例NSTEMI患者为研究对象,依据治疗3个月后患者预后分为预后不佳组(n=41)和预后良好组(n=65)。单因素或和多因素Logistic回归分析影响NSTEMI患者预后的因素;ROC曲线分析动态心电图指标对NSTEMI患者预后的评估价值。结果:单因素分析显示,预后良好组的肌酸激酶同工酶、心肌钙蛋白T水平、QRS时限、QTc间期、ST段压低占比及T波低平或倒置占比均低于预后不佳组(P<0.05);多因素Logistic回归分析显示,肌酸激酶同工酶、QRS时限、QTc间期、ST段压低占比、T波低平或倒置均为NSTEMI患者预后的独立危险因素(P<0.05)。ROC曲线分析显示,QRS时限、QTc间期、ST段压低占比及T波低平或倒置对NSTEMI患者预后评估的曲线下面积(AUC)为0.832、0.827、0.634及0.690,四者联合评估的AUC为0.922。结论:心电图QTc、QRS、ST段压低及T波低平或倒置均可用于评估NSTEMI患者近期预后,且联合运用的评估价值更高。

    Abstract:

    Objective:To analyze the prognostic value of QTc in electrocardiogram and related indicators in patients with non-ST-segment elevation myocardial infarction(NSTEMI).Methods:106 patients with NSTEMI were selected as the research subjects.They were divided into poor prognosis group(n=41)and good prognosis group(n=65)according to the prognosis at 3 months after treatment.Univariate or multivariate Logistic regression analysis was conducted to identify factors affecting the prognosis of NSTEMI pa-tients,the ROC curve analyzed the prognostic value of dynamic electrocardiogram indicators for NSTEMI patients.Results:Univariate a-nalysis showed that the levels of creatine kinase isoenzyme and cardiac troponin T,QRS duration,corrected QT(QTc)interval,the pro-portions of ST-segment depression and T wave flattening or inversion in the good prognosis group were lower and shorter than those in the poor prognosis group(P<0.05).Multivariate Logistic regression analysis showed that creatine kinase isoenzyme,QRS duration,QTc interval,the proportion of ST-segment depression,and T wave flattening or inversion were independent prognostic factors for pa-tients with NSTEMI(P<0.05).ROC curve analysis showed that the areas under the curve(AUC)of QRS duration,QTc interval,the proportion of ST-segment depression,and T wave flattening or inversion for prognosis evaluation of patients with NSTEMI were 0.832,0.827,0.634,and 0.690.The AUC of combined use of the four was the largest,which was 0.922.Conclusion:QTc,QRS,ST-segment depression,and T wave flattening or inversion on electrocardiogram all can be used to evaluate short-term prognosis of NSTEMI.Be-sides,combined use of them can achieve better evaluation results.

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于海珍;何鑫宇;白雄心;.心电图QTc及相关指标对非ST段抬高型心肌梗死患者预后的评估价值[J].川北医学院学报,2025,40(6):755-758.

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  • 在线发布日期: 2025-07-09
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