碎裂QRS波对急性心肌梗死长期预后的预测价值.pdf

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1、授予单位代码10089学号或申请号20122428HebeiMedicalUniversity科学学位碎裂QRS波对急性心肌梗死长期预后的预测价值研究生：王刚导师：王冬梅教授专业：内科学二级学院：白求恩国际和平医院2015年3月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师（或指导小组）的指导下，由本人独立完成。本学位论文研究所获得的研究成果，其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公幵和使用。凡发表与学位论文主要内容相关的论文，第一署名为单位河北医科大学，

2、试验材料、原始数据、申报的专利等知识产权均归河北医科大学所有。否则，承担相应法律责任。惑驗研究生签名导师签章：二级考_领导f章r曰丨欠竿叙•'月河北医科大学研究生学位论文独创性声明本论文是在导师指导下进行的研究工作及取得的研究成果，除了文中特别加以标注和致谢等内容外，文中不包含其他人已经发表或撰写的研究成果，指导教师对此进行了审定。本论文由本人独立撰写，文责自负。研究生签名：导师签章-年？月7曰目录中文摘要················································

3、································1英文摘要················································································3英文缩写···············································································5研究论文碎裂QRS波对急性心肌梗死长期预后的预测价值前言·······················

4、·························································6资料与方法······································································7结果················································································9附图··································

5、············································11附表··············································································12讨论······································································14结论·················································

6、·····························20参考文献········································································20综述碎裂QRS波的研究进展及临床意义····································25致谢····················································································39

7、个人简历··············································································40中文摘要碎裂QRS波对急性心肌梗死长期预后的预测价值摘要目的：通过对急性心肌梗死（Acutemyocardialinfarction，AMI）患者体表心电图的分析，探讨急性心肌梗死患者心电图中碎裂QRS波群（fragmentedQRS，fQRS）的发生情况，碎裂QRS波群对急性心肌梗死预后的预测价值，以及碎裂QRS波群与冠状动脉病变范围

8、和严重程度的关系。方法：对963例急性心肌梗死(Acutemyocardialinfarction，AMI)患者入院24小时内的心电图进行详细分析，根据是否出现fQRS波群分为fQRS及非fQRS两组。比较两组患者年龄、性别、病因、病程及冠脉血管病变等基础情况，并进行系统随访12个月，观察两组患者的心血管事件发生率，主要终点事件包括心源性死亡和全因死亡。亚组分析讨论次要终点事件包括再发心绞痛、因心血管事件再住院。亚组分析分别讨论PCI组内及非PCI组内f