摘要目的 探讨不同平面QRS-T夹角水平对急性心肌梗死(AMI)患者心功能不全的评估价值.方法 选取2010年1月至2016年5月本院收治的186例AMI患者作为研究对象,采用系统性回顾法分析患者的临床及随访资料,测量所有患者的左室射血分数(LVEF)、平面QRS-T夹角、白细胞(WBC)计数及肌酸激酶同工酶(CK-MB)水平,并比较上述指标的差异.结果 (1)心功能不全患者较心功能正常患者年龄较大,两组梗死部位及合并高血压和糖尿病分布差异具有统计学意义(P＜0.05);(2)心功能正常者其WBC及CK-MB水平较心功能不全者低,且平面QRS-T夹角＜50°、90°≤QRS-T夹角＜100°及QRS-T夹角≥100°所占比例在心功能正常和心功能不全患者间比较差异有统计学意义(P＜0.05),且随着LVEF值的降低,QRS-T夹角越大;(3)90°≤QRS-T夹角＜100°和QRS-T夹角≥100°评估心功能不全的敏感度和特异度分别为96.32％和95.98％,95.02％和94.68％,与WBC、CK-MB及其他QRS-T夹角敏感度和特异度比较差异均有统计学意义(P＜0.05).结论 不同平面QRS-T夹角对评估心功能不全均存在一定的临床价值,但当90°≤QRS-T夹角＜100°和QRS-T夹角≥100°时具有较佳敏感度和特异度,两者间无差异,故临床上可将QRS-T夹角≥90°作为评估心功能不全的指标之一.

abstractsObjective To investigate the evaluation of different levels of QRS-T angle in patients with acute myocardial infarction (AMI).Methods A total of 186 AMI patients from January 2010 to May 2016 in our hospital as the research object.The review method was used to analyze the clinical and followup data of the patients.The left ventricular ejection fraction (LVEF),plane QRS-T angle,white blood cell (WBC) and isoenzyme count and creatine (CK-MB) were evaluated and compared.Results (1) The age of the patients with heart failure was larger than that in the patients with normal heart function,and the proportion of myocardial infarction and hypertension and diabetes distributionthe in two groups had statistically significant difference (P ＜ 0.05);(2) The WBC and CK-MB levels of patients with normal cardiac function were lower than those in patients with heart failure.The planar QRS-T angle ＜ 50 degrees,between 90 degrees and 100 degrees and more than 100 degrees were statistically significant between normal heart function patients and failure heart function patients (P ＜ 0.05),and with the decrease of LVEF the levels of QRS-T angle increased;(3) The sensitivity and specificity of 90 degrees ≤ QRS-T angle ＜ 100 degrees and QRS-T angle greater than 100 degrees were 96.32％ and 95.98％,95.02％ and 94.68％,and those were different with the sensitivity and specificity of WBC,CK-MB and other QRS-T angle(P ＜ 0.05).Conclusions Different planar QRS-T angle on the evaluation of cardiac function insufficiency has certain clinical value,but when the 90°≤ QRS-T angle ＜ 100° and QRS-T angle ≥ 100° have better sensitivity and specificity with no difference between two QRS-T angles.The QRS-T angle≥ 90° can be used as one of the indicators for the evaluation of cardiac function insuffieiency.