摘要
目的：分析急性心肌梗塞（AMI）患者早期QT离散度（QTd）及溶栓治疗前后QTd、QTcd的变化，探讨其在AMI时室性心律失常预测及溶栓疗效评定中意义。方法：测量98例AMI患者常规12导联心电图QT间期及其中40例经溶栓治疗者溶栓前后QT间期，计算其QTd及校正后的QT离散度（QTcd），并设正常对照组。结果：①AMI组QTd、QTcd均明显大于正常对照组（P＜0．001）；②室性心律失常者QTd、QTcd较无心律失常者均有显著延长（P＜0．001），且与恶性程度有关；③AMI患者QTd、QTcd大小与梗塞部位有关，其增大程度依次为复合壁＞广泛前壁＞前壁＞前间壁＞下壁。④溶栓再通组（24例）溶栓后2h、24h、3d、1W的QTd、QTcd较溶栓前缩短，均有统计学意义；未通组（16例）溶栓前后QTd及QTcd无此变化。（P＞0．05）溶栓后，未通组与再通组相比QTd、QTcd均有显著性差异。结论：AMI的QTd、QTcd延长者，室性心律失常事件发生率增高，可作为预测室性心律失常的指标；溶栓后，QTd、QTcd缩短，提示溶栓后血管再通，故亦可作为溶栓后梗塞血管是否再通的判断指标。
To analyse the changs of QT dispersion(QTd) in patients with acute myocardial infartion(AMI)before and after thrombolytic therapy, and its significance to predict ventri -cular arrhythmias and to assess ef-fects of thrombolytic therapy in patients with AMI.Methods QT dispersion (QTd) and corrected QT dispersion (QTcd)in 98 patients with AMI and 40 Patients with before and after thrombolyfic therapy in them were measured from the 12lead ECG, with 100 cases of healthy people as control group.Results(1) QTd and QTcd of groups with AMI were verylarger than control group (P< 0.001); (2) QTd and QTcd of the ventricular arrhythmias were evidently larger thannon-arrhythmias (P<0.001), and related to degree of anhyhhaas. (3) QTd and QTcd in Patients wyth AMI wererealted to area of infaretion, its subsequence of degree was coplex wall MI>extensive anterior MI> anterior MI>ante-riorseptal MI > inferior MI. (4) It was found that QTd and QTcd were shortted in 24 patients with successful thrombolyt-ic therapy at 2h,24h,3d and 1W later (P<0.05). But QTd and QTd showed no significant change in 16 Patientswith unsuccessful thrombolytic therapy (P<0.001).The differences of QTd and QTcd between successful and unsue- cessful patients at 15min,2h,24h,3d and 1W later were significant(P<0.05 ). Conclusions The increasc of QTd andQTcd may be a mark of susceptibility to serious ventricular arrhythmia in patients with AMI and may be a pledict stau-dard of ventricular arrhythmia.The decrease of after thrombolytic therapy may indicate a srccessful repefusion in patients with AMI.
出处
《长治医学院学报》
1999年第4期256-259,共4页
Journal of Changzhi Medical College
关键词
急性
心肌梗塞
QT离散度
溶栓治疗
QT dispersion
Thrombolytic therapy
Ventricular arrhythmias
