摘要
目的 观察冠心病患者在经皮冠状动脉腔内成形术 (PTCA)及支架植入术后QT离散度(QTd)的变化。方法 44例冠心病患者经PTCA及支架植入术后血管再通者纳入研究。术前一周内及术后 48h内分别记录体表 12导联同步心电图 ,测量QTd及QTc离散度 (QTcd)。为评价冠状动脉造影对QTd及QTcd可能产生的影响 ,我们还测量了同期 10 8例行冠状动脉造影术的患者手术前后的QTd及QTcd。结果 (1) 10 8例行冠状动脉造影术者及其亚组 (术前QTd延长组、正常组 ,QTcd延长组、正常组 ,单支病变组 ,二支病变组 )手术前后QTd及QTcd差异均无显著性 ;(2 )PTCA及支架植入术组手术前后QTd差异也无显著性 ,但QTcd却从术前的 (5 8 9± 33 3)ms缩短至术后的 (4 7 6± 2 0 9)ms(P <0 0 5 )。亚组分析表明 :术前QTd延长组 (75 4± 2 5 2 )ms术后明显缩短 (4 7 5± 19 6 )ms,P <0 0 1;术前QTcd延长组 (95 3± 30 3)ms术后也明显改善 (5 2 5± 2 5 6 )ms ,P <0 0 1;单支病变组手术后QTd(4 1 6± 16 9)ms及QTcd(4 4 3± 18 2 )ms均较术前 [QTd及QTcd分别为 (5 5 5± 2 6 4)ms及 (6 0 3± 31 1)ms]明显缩短 (P均 <0 0 5 ) ;而术前QTc或QTcd正常组、二支病变组手术后QTc及QTcd均无明显变化。结论 PTCA及支架术可明显缩短QTcd ;
To evaluate the effect of coronary revascularization, by successful coronary angioplasty or stent implantation, on QT dispersion (QTd) and QTc dispersion (QTcd) Methods Of 152 patients studied, 44 patients underwent successful percutaneous transluminal coronary angioplasty (PTCA) or stent implantation, another 108 patients underwent coronary angiography QTd or QTcd was defined on each ECG as the difference between the maximal and minimal measurements of QT interval or QTc interval Maximal and minimal QT interval and QTd were measured using 12-lead electrocardiography within 7 days before and 48 h after procedure Results (1) After coronary angiography, no change of QTd or QTcd was observed either in 108 patients or in it's subgroups which includes those with prolonged QTd or QTcd at baseline, those with normal QTd or QTcd before produre, and those of single vessel disease, of double vessel disease, or of triple vessel disease (2) In 44 patients underwent PTCA or stent implantation, QTd decreased from (58 9±30 3)ms at baseline to (47 6±20 9)ms after the procedure ( P <0 05), but QTd remained unchanged Results in subgroups were also studied In patients with prolonged QTd ( n =21) or QTcd ( n =15) at baseline, QTc and QTcd decreased from (75 4±25 2)ms and (95 3±30 3)ms, to (47 5±19 6)ms ( P <0 01) and (52 5±25 61)ms ( P <0 01), respectively In 30 patients of single vessel disease, QTd and QTcd were (55 5±26 4)ms and (60 3±31 1)ms, respectively, before the procedure After the procedure, QTd and QTcd were decreased to (41 6±16 9)ms and (44 3±18 2)ms ( P <0 05), respectively In patients with normal QTc ( n =23) or QTcd ( n =29) at baseline, or those of double vessel disease ( n =14), no change of QTc or QTcd was found after the procedure of revascularization Conclusion Successful PTCA or stent implantation is associated with the reduction of QTcd Subgroup study shows that in patients with prolonged QTc or QTcd at baseline, and in those of single vessel disease, QTc or QTcd can also be decreased by the procedure of revascularization
出处
《中国介入心脏病学杂志》
2000年第3期127-129,共3页
Chinese Journal of Interventional Cardiology
关键词
QT离散度
冠状动脉疾病
血管成形术
支架
治疗
QT dispersion
Coronary artery disease
Angioplasty, transluminal, percutaneous coronary
Stent
