心电图V1导联P波终末电势水平对急性冠脉综合征患者预后的影响

Effect of P-wave terminal force in lead V1 on prognosis of patients with acute coronary syndrome

摘要:

目的 探讨心电图V1导联P波终末电势(PtfV1)对急性冠脉综合征(ACS)患者预后的影响。方法 收集2017年5月至2018年6月期间在北京航天总医院干部医疗科及心血管内科住院治疗的ACS患者308例。根据PtfV1值分为3组:PtfV1<20mm·ms组(n＝106),20mm·ms≤PtfV1≤40mm·ms组(n＝100)和PtfV1>40mm·ms组(n＝102)。比较各组患者临床资料。随访时间不少于6个月,比较3组患者主要不良心血管事件(MACEs)发生率。采用SPSS 20.0软件进行数据处理。无MACEs生存时间采用Kaplan-Meier生存曲线分析。结果 随访时间6~30(12.5±7.2)个月。截止随访结束,PtfV1<20mm·ms组发生MACEs 2例(占1.89%),20mm·ms≤PtfV1≤40mm·ms组发生MACEs 7例(占7.00%),PtfV1>40mm·ms组发生MACEs 12例(占11.76%)。Kaplan-Meier分析表明,3组患者的MACEs发生率间差异具有统计学意义(χ²=8.152,P=0.017),其中PtfV1<20mm·ms组患者MACEs发生率显著低于PtfV1>40mm·ms组(χ²=8.079,P=0.004)。结论 PtfV1水平与ACS患者心血管事件发生率有关,可以作为ACS患者远期心血管事件发生率及预后的预测指标。

Abstract:

Objective To investigate the association between the P-wave terminal force in lead V1 (PtfV1) and prognosis in the electrocardiogram (ECG) of the acute coronary syndrome (ACS) patients. Methods A total of 308 ACS patients were selected from Cadre′s Ward and the Departments of Cardiology of Beijing Aerospace Hospital, during May 2017 and June 2018. All patients underwent electrocardiogram examination, and they were divided into 3 groups according to the value of PtfV1:PtfV1<20mm·ms group (n=106), 20mm·ms≤PtfV1≤40mm·ms group (n=100) and PtfV1>40mm·ms group (n=102). All of the patients were followed up for at least 6 months. The clinical data and the incidences of major adverse cardiovascular events (MACEs) were compared in the 3 groups. SPSS statistics 20.0 was used for data analysis, and Kaplan-Meier survival analysis was applied to analyze the differences in survival rates between non-MACEs patients of the 3 groups. Results During the follow-up of 6-30 (12.5±7.2) months, the incidence of MACEs was 1.89% (2 cases) in the PtfV1<20mm·ms group, 7.00% (7 cases) in the 20mm·ms≤PtfV1≤40mm·ms group and 11.76% (12 cases) in the PtfV1>40mm·ms group. Kaplan-Meier analysis showed that significant difference were seen in the survival rate among the 3 groups (Chi-square=8.152, P=0.017), with that of the PtfV1<20mm·ms group obviously lower than that of the PtfV1>40mm·ms group (Chi-square=8.079, P=0.004). Conclusion PtfV1 is associated with the incidence of cardiovascular events in ACS patients, and can be used as a predictor for prognosis and the incidence of long-term cardiovascular events.