| 陈海威,李 娜,王 磊,翟红霞,夏云峰.比索洛尔干预对于ACS患者急诊PCI术后QRS-T夹角改变及其临床意义研究[J].,2017,17(1):84-87 |
| 比索洛尔干预对于ACS患者急诊PCI术后QRS-T夹角改变及其临床意义研究 |
| Influence of Bisoprolol Intervention on QRS-T Angle in ACS Patients after Emergency PCI Treatment and Its Clinical Significance |
| 投稿时间：2016-09-05 修订日期：2016-09-19 |
| DOI：10.13241/j.cnki.pmb.2017.01.021 |
| 中文关键词: 比索洛尔 急性冠脉综合征 PCI术 QRS-T夹角 |
| 英文关键词: Bisoprolol Acute coronary syndrome PCI QRS-T angle |
| 基金项目:全军后勤科研计划面上项目（CWS14J070） |
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| 中文摘要: |
| 摘要 目的：探讨比索洛尔干预对于急性冠脉综合征（acute coronary syndrome，ACS）患者急诊经皮冠状动脉介入治疗（percuta- neous coronary intervention，PCI）术后QRS-T转角改变及其临床意义。方法：连续纳入100例ACS患者，急诊PCI术开通罪犯血管，术后分为比索洛尔组和常规治疗组。另选50名年龄相似，非冠心病志愿者作为对照组。观察术前和术后额面QRS-T夹角情况与术后1年主要心脏不良事件(major adverse cardiovascular events，MACE)发生率的相关性。结果：ACS患者PCI术前额面QRS-T夹角均明显高于对照组（F=4.528, P=0.033）。在急诊PCI后第三天可见比索洛尔组ACS患者额面QRS-T夹角明显回落（74.9±11.2° vs. 50.3±15.2°，P<0.05）。比索洛尔治疗与ACS患者急诊PCI术后额面QRS-T夹角改变（r=0.783，P=0.013）成正相关，而与MACE发生率（r=-0.512，P=0.034）存在负相关。ACS患者急诊PCI术后使用早期加用比索洛尔治疗后可以使MACE发生风险降低23%（P=0.012）、△额面QRS-T夹角（每增加1°）使MACE风险降低8%（P=0.041），而Gensini评分（每增加1分）使MACE发生风险升高32%（P=0.035）。结论：ACS患者PCI术后早期应用比索洛尔治疗可以促进额面QRS-T夹角水平回落。额面QRS-T夹角回落幅度与MACE的发生相关。 |
| 英文摘要: |
| ABSTRACT Objective: To evaluate the influence of Bisoprolol intervention on QRS-T angle in patients with acute coronary syn- drome (ACS) after emergency percutaneous coronary intervention (PCI) and its clinical significance. Methods: 100 ACS patients were consecutively enrolled into the study and divided into Bisoprolol group and normal treatment group after PCI. Another 50 age-matched and non-coronary heart disease cases were enrolled at the same time as control group. The QRS-T angel before and after the intervention and their correlation with the incidence of major adverse cardiovascular events (MACE) one year after PCI. Results: Before the treatment, ACS patients showed a higher level of QRS-T angle compared with controls. Levels of QRS-T angle in bisoprolol group showed a signif- icant reduction on the third day after PCI treatment compared with those in normal treatment group (74.9±11.2° vs. 50.3±15.2°, P<0.05). Correlation analysis showed that bisoprolol treatment was positively associated with changes of QRS-T angle (r=0.783, P=0.013), while negatively related with MACE incidence rate (r=-0.512, P=0.034). Logistic regression analysis showed that bisoprolol admin- istration during early stage after PCI of ACS patients can decrease MACE incidence rate 23% (P=0.012), △QRS-T angle (per 1°) could decrease MACE incidence rate 8% (P=0.041), and Gensini score could make MACE incidence rate increase 32% (P=0.035). Conclusion: Early bisoprolol treatment may enhance the reduction of QRS-T angle in ACS patients following PCI. The range of QRS-T angle is asso- ciated with occurrence rate of MACE. |
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