摘要
目的 分析心电图表现对急性心肌梗死（AMI）患者经皮冠状动脉介入（PCI）术后恶性心律失常（MVA）的风险预测价值。方法 选取2021年3月至2024年3月在本院行PCI手术治疗的304例AMI患者作为研究对象，并根据患者术后发生MVA的情况分为两组。对比两组患者的心电图参数[校正T波峰末间期（Tp-Tec）、校正QT间期（QTc）、T波峰末间期/QT间期（Tp-Te/QT）、Tp-Te离散度、QT离散度、破碎QRS(f QRS)波]及其他临床资料，分析术后MVA的风险因素，并采用受试者工作特征曲线分析心电图参数预测术后MVA的价值。结果 共304例患者，其中有82例患者PCI术后发生MVA，发生率26.97%。发生组Killip心功能Ⅲ/Ⅳ级占比、C反应蛋白（CRP）、f QRS波占比、Tp-Tec、QTc、Tp-Te/QT、QT离散度均高于未发生组（P<0.05），血钾低于未发生组（P<0.05）。Killip心功能Ⅲ/Ⅳ级、CRP、血钾、f QRS波、Tp-Tec、QTc、Tp-Te/QT、QT离散度均为术后MVA的影响因素（P<0.05）。f QRS波、Tp-Tec、QTc、Tp-Te/QT、QT离散度联合预测术后MVA的灵敏度、特异度、曲线下面积（AUC）分别为95.15%、75.68%、0.924，且灵敏度高于单项参数预测，AUC也高于单项参数预测（P<0.05），特异度与单项参数预测相近。结论 f QRS波、Tp-Tec、QTc、Tp-Te/QT、QT离散度是AMI患者PCI术后MVA的影响因素，均对MVA有一定的预测价值，且上述心电图参数联合预测的价值更高。
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