目的 探究碎裂QRS波在新战士复检中的发生率、 分布特点及在训练中的预警意义.方法 回顾性分析某部3954例(男性3631例,女性323例)入伍新战士复检心电图,收集静息状态下的常规12导联心电图,筛选出fQRS波,统计fQRS波的发生率及发生部位.依据年龄18～25岁划分为八个组,男兵按兵种分为六组:空军1部、陆军1部、武警、通讯、空军2部、陆军2部,再按fQRS波出现导联分为肢导组、胸导组、胸导+肢导组.结果 fQRS波的整体发生率在性别和年龄上无统计学差异(P>0.05).fQRS发生率在入伍战士各年龄段无统计学差异(P>0.05).六个兵种男兵fQRS波发生率之间存在统计学差异(P<0.05).fQRS波同时发生于胸导和肢导的比例明显大于单纯发生于胸导/肢导的比例,具有显著差异(P<0.05).结论 fQRS波的发生率与运动强度之间具有一定联系,这种不同运动强度造成的fQRS波发生率之间差异可能与心肌损伤有一定关系.

OBJECTIVE:To investigate the effects of mitochondrion-targeted cyanine fluorescent small molecule IR-61 on cardiac injury induced by exhaustive exercise in rats.METHODS:Thirty-six adult male SD rats were randomly divided into 3 groups(n=12),control group (Ctrl), exhaustive exercise group (EE) and IR-61+ exhaustive exercise group (IR-61+EE). IR-61+EE group were intraperitoneally injected with 2 mg/kg IR-61 at the same time on day 1, 4 and 7. One hour after the end of the last drug administration, the two exhaustive exercise groups were subjected to exhaustive exercise modeling. The rats were placed on an animal treadmill with a slope of 0° at a speed of 10~15 m/min to coordinate their limbs running posture, and then ran at a speed of 25~30 m/min until exhaustion about 15 minutes later. After the animal models established, ECG was recorded by physiological recorder, myocardial injury was observed by light microscope, mitochondrial injury was observed by transmission electron microscope, myocardial cell apoptosis was detected by TUNEL method, markers of myocardial injury were detected by ELISA, and myocardial mitochondrial respiration rate was measured by high-resolution Oxygraph-2K mitochondrial instrument.RESULTS:① Compared with Ctrl group, heart rate was increased, PR interval was shortened, QRS interval was prolonged, QTc was prolonged and ST segment was depressed significantly in EE group (P＜0.05). In EE group, myocardial fiber fracture and mitochondrial inner chamber swelling were obvious, mitochondrial crest was fuzzy, mitochondrial outer membrane was incomplete, and a large number of mitochondrial rupture and fusion were visible. In EE group, TUNEL staining cells were abundant, chromatin concentration and marginalization, nuclear membrane lysis, chromatin fragmentation into massive apoptotic bodies, apoptosis score increased (P＜0.05). The levels of creatine kinase isoenzyme-MB (CK-MB), cardiac troponin I(cTn-I) and N-terminal B-type natriuretic peptide (NT-proBNP) were increased in EE group (P＜0.05). Basal respiration rate, oxidative respiration rate of fatty acids and respiration rate of complex Ⅰ, Ⅱ and Ⅳ were all decreased (P＜ 0.05). ② Compared with EE group, the heart rate in IR-61+EE group was increased, PR interval was prolonged, QRS interval was shortened, QTc was shortened, ST segment was not significantly depressed (P＜0.05). In IR-61+EE group, myocardial fiber arrangement was loose, no obvious fracture was observed, mitochondrial inner ventricle was swelling, mitochondrial outer membrane was intact, TUNEL stained cells and unstained cells were observed, the overall morphology was more similar to Ctrl group. Apoptosis index was decreased (P＜0.05), the levels of CK-MB and cTn-I were decreased in IR-61+EE group (P＜0.05). The oxidative respiration rate of fatty acids and the respiration rate of complex Ⅱ and Ⅳ were increased (P＜0.05).CONCLUSION:Mitochondrion-targeted cyanine fluorescent small molecule IR-61 can improve cardiac electrical activity, reduce myocardial cell injury and mitochondrial injury, reduce myocardial cell apoptosis, and improve the myocardial mitochondrial energy metabolism condition in exhausted rats.

目的 对比探讨新型药物洗脱支架火鹰(Firehawk)支架及XIENCE V依维莫司支架在糖尿病合并急性冠脉综合征(ACS)群体中的有效性及安全性.方法 回顾性分析2017年2月至2019年8月于陆军第八十二集团军医院心脏介入中心接受冠状动脉(冠脉)介入治疗的确诊ACS合并2型糖尿病患者62例.按单一接受不同支架种类分为接受Firehawk支架的Firehawk组(30例)及接受XIENCE V支架的XIENCE V组(32例).对比观察两组患者介入治疗术后12个月内累积心血管不良事件发生情况.结果 XIENCE V组中男性28例,女性4例;年龄37～91岁,平均(59.9±13.1)岁;Firehawk组中男性19例,女性11例.年龄30～79岁,平均(60.4±11.9)岁.两组患者吸烟、高血压及高脂血症情况及实验室检查结果比较,差异均无统计学意义(P>0.05).两组手术成功率均为100.0％;随访中仅XIENCE V组失访1例,总随访率为98.4％.12个月内心绞痛:Firehawk组发生1例(3.33％)和XIENCE V组1例(3.23％),非致死性心肌梗死发生率:Firehawk组1例(3.33％),XIENCE V组0例(0％);心源性死亡发生率:Firehawk组0例(0％),XIENCE V组升主动脉瘤破裂死亡1例(3.23％),累积主要心血管不良事件发生率:6.67％vs.6.45％(P>0.05).结论 应用Firehawk支架治疗糖尿病合并急性冠脉综合征安全有效,在主要心脏不良事件发生率比较无明显差异,安全性及有效性不劣于XIENCE V支架.