2024 年第 3 期 第 19 卷

非ST段抬高型心肌梗死患者经皮冠状动脉介入治疗后病理性Q波持续状态与预后的关系

Relationship between pathological Q-wave status and prognosis after percutaneous coronary intervention in patients with non ST segment elevation myocardial infarction

作者：张国勇马铮刘佩林连政郭彩霞

英文作者：Zhang Guoyong Ma Zheng Liu Peilin Lian Zheng Guo Caixia

单位：首都医科大学附属北京同仁医院心血管中心，北京100730

英文单位：Cardiovascular Center Beijing Tongren Hospital Capital Medical University Beijing 100730 China

关键词：非ST段抬高型心肌梗死；经皮冠状动脉介入；病理性Q波持续状态

英文关键词：NonSTsegmentelevationmyocardialinfarction;Percutaneouscoronaryintervention;PathologicalQ-wavestatus

• 摘要：

• 目的 探讨非ST段抬高型心肌梗死（NSTEMI）患者经皮冠状动脉介入（PCI）治疗后病理性Q波持续状态与预后的关系。方法 回顾性分析2020年8月至2022年8月首都医科大学附属北京同仁医院收治的147例NSTEMI患者的临床资料，根据PCI治疗后1年是否发生主要不良心血管事件（MACE），将患者分为MACE组（52例）和非MACE组（95例）。比较2组患者临床资料，采用多因素Logistic回归方法分析NSTEMI患者PCI治疗后预后的影响因素。采用交互作用检验分析评估患者治疗后病理性Q波持续状态对预后的预测价值。结果 2组患者全球急性冠状动脉事件注册(GRACE)评分、中性粒细胞与淋巴细胞比值（NLR）、高密度脂蛋白胆固醇（HDL-C）、肌酸激酶同工酶（CK-MB）、心肌肌钙蛋白I（cTnI）、左心室射血分数（LVEF）、病理性Q波状态比较差异均有统计学意义（均P＜0.05）。多因素Logistic回归分析结果显示，GRACE评分、LVEF、NLR、HDL-C、CK-MB、cTnI、病理性Q波状态均为NSTEMI患者PCI治疗后预后的影响因素（比值比=3.017、3.868、2.562、2.161、4.093、5.604、7.556，均P＜0.05）。病理性Q波持续状态对NSTEMI患者PCI治疗后预后具有一定预测价值（风险比=5.791，95%置信区间：2.207～9.894,P＜0.001）。结论 NSTEMI患者PCI治疗后病理性Q波持续状态是患者预后的重要影响因素，对患者预后具有一定预测价值。

• Objective To investigate the relationship between pathological Q-wave status and prognosis in patients with non ST segment elevation myocardial infarction (NSTEMI) after percutaneous coronary intervention (PCI). Methods The clinical data of 147 NSTEMI patients admitted to Beijing Tongren Hospital, Capital Medical University from August 2020 to August 2022 were retrospectively analyzed. According to whether major adverse cardiovascular events (MACE) occurred within 1 year after PCI, the patients were divided into MACE group (52 cases) and non-MACE group (95 cases). The clinical data of the two groups were compared, and multivariate Logistic regression was used to analyze the influencing factors of the prognosis of NSTEMI patients after PCI. The interaction test was used to evaluate the predictive value of pathological Q-wave status on prognosis after treatment. Results There were statistically significant differences in the global registry of acute coronary events (GRACE) score, neutrophil to lymphocyte ratio (NLR), high-density lipoprotein cholesterol (HDL-C), creatine kinase isoenzyme (CK-MB), cardiac troponin I (cTnI), left ventricular ejection fraction (LVEF) and pathological Q-wave status between the two groups(all P＜0.05). Multivariate Logistic regression analysis showed that GRACE score, LVEF, NLR, HDL-C, CK-MB, cTnI and pathological Q-wave status were all influencing factors for the prognosis of NSTEMI patients after PCI treatment(odds ratios=3.017, 3.868, 2.562, 2.161, 4.093, 5.604, 7.556, all P＜0.05). The pathological Q-wave status has a certain predictive value for the prognosis of NSTEMI patients after PCI treatment(hazard ratio=5.791，95% confidence interval：2.207-9.894,P＜0.001). Conclusions  The pathological Q-wave status is an important factor affecting the prognosis of NSTEMI patients after PCI treatment, and has certain predictive value for the prognosis of patients.