现代仪器与医疗

心电图平面QRS-T夹角对NSTE-ACS患者预后的评估价值分析

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吕艳侠 ^a , 董华英 ^b , 郑晗 ^b

现代仪器与医疗 | 临床研究 2025,31(6): 41-47

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现代仪器与医疗 |临床研究 2025 , 31 (6) : 41 -47

心电图平面QRS-T夹角对NSTE-ACS患者预后的评估价值分析

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吕艳侠^a, 董华英^b, 郑晗^b

作者信息

^a.徐州市中医院　中医内科，徐州　221000

^b.徐州市中医院　心电图室，徐州　221000

作者简介:

吕艳侠，女，本科，主治中医师，研究方向：中医内科

Analysis of the evaluation value of the planar QRS-T angle of electrocardiogram for the prognosis of patients with NSTE-ACS

Yanxia Lyu^a, Huaying Dong^b, Han Zheng^b

Affiliations

^a.Internal Medicine of Traditional Chinese Medicine, Xuzhou Hospital of Traditional Chinese Medicine, Xuzhou 221000, China

^b.Electrocardiogram Room, Xuzhou Hospital of Traditional Chinese Medicine, Xuzhou 221000, China

出版时间: 2025-12-10 doi: 10.11876/mimt202506007

文章导航

摘要

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目的

探究心电图平面QRS-T夹角对非ST段抬高型急性冠状动脉综合征（non-ST-segment elevation acute coronary syndrome，NSTE-ACS）患者预后的评估价值。

方法

回顾性纳入2023年3月至2024年3月在我院接受治疗的121例NSTE-ACS患者的临床资料，连续随访1年，根据随访期间是否发生主要心脏不良事件将患者分为预后良好组和预后不良组，比较两组临床资料和心电图参数，采用Logistic回归分析影响NSTE-ACS患者预后的因素，使用Pearson相关性检验分析NSTE-ACS患者全球急性冠状动脉事件注册（global registry of acute coronary events，GRACE）风险评分、入院高敏心肌肌钙蛋白I（high-sensitivity myocardial troponin I，hs-cTnI）水平与心电图平面QRS-T夹角的关系，应用受试者工作特征（receiver operating characteristic，ROC）曲线分析GRACE风险评分、入院hs-cTnI水平、平面QRS-T夹角对NSTE-ACS患者预后的评估价值。

结果

121例NSTE-ACS患者共发生主要心脏不良事件35例，主要心脏不良事件率为28.93%；预后不良组GRACE风险评分、入院hs-cTnI水平以及平面QRS-T夹角均高于预后良好组（P<0.05）；高GRACE风险评分、高入院hs-cTnI水平、平面QRS-T夹角增大是导致NSTE-ACS患者预后不良的危险因素（P<0.05）；NSTE-ACS患者GRACE风险评分、入院hs-cTnI水平与平面QRS-T夹角均呈中等正相关（P<0.05）；GRACE风险评分、入院hs-cTnI水平、平面QRS-T夹角均对NSTE-ACS患者不良预后有一定预测价值，其中，3项联合检测预测效能最高，AUC为0.931、灵敏度为97.14%、特异度为72.09%。

结论

NSTE-ACS预后不良患者心电图平面QRS-T夹角显著增大，平面QRS-T夹角增大是NSTE-ACS患者预后不良的危险因素和预测因子，但其与GRACE风险评分、入院hs-cTnI水平联合检测的预测效能最高。

关键词

非ST段抬高型急性冠状动脉综合征 / 心电图 / 平面QRS-T夹角 / 预后

Abstract

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Objective

To explore the evaluation value of the QRS-T angle on the electrocardiogram plane for the prognosis of patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS).

Methods

The clinical data of 121 patients with NSTE-ACS who were treated in our hospital from March 2023 to March 2024 were retrospectively included. They were followed up for one consecutive year. The patients were divided into the good prognosis group and the poor prognosis group based on whether major adverse cardiac events occurred during the follow-up period. The clinical data and electrocardiogram parameters of the two groups were compared. Logistic regression was used to analyze the factors influencing the prognosis of patients with NSTE-ACS. Pearson correlation was used to analyze the relationship between the global registry of acute coronary events (GRACE) risk score, the level of high-sensitivity myocardial troponin I (hs-cTnI) at admission and the QRS-T angle on the electrocardiogram plane in patients with NSTE-ACS. The receiver operating characteristic (ROC) curve was applied to evaluate the value of GRACE risk score, the level of hs-cTnI at admission, and the QRS-T angle in predicting the prognosis of patients with NSTE-ACS.

Results

Among 121 patients with NSTE-ACS, 35 major adverse cardiac events occurred, and the rate of major adverse cardiac events was 28.93%. The GRACE risk score, admission hs-cTnI level and QRS-T angle in the poor prognosis group were all higher than those in the good prognosis group (P<0.05). High GRACE risk score, high hs-cTnI level, and increased QRS-T angle are risk factors for poor prognosis in patients with NSTE-ACS (P<0.05); The GRACE risk score of patients with NSTE-ACS, the hs-cTnI level at admission and the QRS-T angle were moderately positively correlated (P<0.05). GRACE risk score, admission hs-cTnI level, and QRS-T angle all have certain predictive values for the poor prognosis of patients with NSTE-ACS. Among them, the combined detection of the three has the highest predictive efficacy, with an AUC of 0.931, a sensitivity of 97.14%, and a specificity of 72.09%.

Conclusion

The QRS-T angle on the electrocardiogram plane is significantly increased in patients with poor prognosis of NSTE-ACS. The increase in the QRS-T angle is a risk factor and predictor of poor prognosis in patients with NSTE-ACS, but it has the highest predictive efficacy when combined with GRACE risk score and admission hs-cTnI level.

Key words

Non-ST-segment elevation acute coronary syndrome / Electrocardiogram / QRS-T angle / Prognosis

引用本文

吕艳侠, 董华英, 郑晗. 心电图平面QRS-T夹角对NSTE-ACS患者预后的评估价值分析. 现代仪器与医疗, 2025 , 31 (6) : 41 -47 . DOI: 10.11876/mimt202506007

Yanxia Lyu, Huaying Dong, Han Zheng. Analysis of the evaluation value of the planar QRS-T angle of electrocardiogram for the prognosis of patients with NSTE-ACS[J]. Modern Instruments & Medical Treatment, 2025 , 31 (6) : 41 -47 . DOI: 10.11876/mimt202506007

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2025年第31卷第6期

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doi: 10.11876/mimt202506007

首发时间：2026-10-23
出版时间：2025-12-10

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^a.徐州市中医院　中医内科，徐州　221000

^b.徐州市中医院　心电图室，徐州　221000

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2种不同金属材料的力学参数

科 Family	属数 Number of genus	种数 Number of species	占总种数比例 Percentage of total species (%)	属 Genus	种数 Number of species	占总种数比例 Percentage of total species (%)
鹅膏菌科Amanitaceae	2	11	5.26	鹅膏菌属 Amanita	10	4.78
小菇科 Mycenaceae	2	12	5.74	丝盖伞属 Inocybe	5	2.39
多孔菌科 Polyporaceae	8	14	6.70	蜡蘑属 Laccaria	5	2.39
红菇科 Russulaceae	3	23	11.00	小皮伞属 Marasmius	6	2.87
				小菇属 Mycena	11	5.26
				光柄菇属 Pluteus	5	2.39
				红菇属 Russula	17	8.13
				栓菌属 Trametes	5	2.39

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