目的 观察阿托伐他汀钙对陈旧性心肌梗死患者QT离散度及T峰末间期的影响.方法 回顾性分析2009年1月到2011年12月陈旧性心肌梗死且连续服用阿托伦他汀钙的患者55例为观察组,连续口服阿托伐他汀钙20～40 mg/d≥3个月;同期陈旧性心肌梗死患者55例因各种原因未使用他汀类药物者为对照组;连续口服阿托伐他汀钙20～40 mg/d≥3个月的稳定型心绞痛(SAP)患者30例为SAP组.所有患者在基线及服用他汀药物3个月后进行QT离散度及校正T峰末间期测量.结果 用药前,观察组和对照组校正T峰间期均明显长于SAP组[(100±6)、(98±6)ms比(86±6)ms,均P＜0.05],QT离散度与SAP组比较,差异无统计学意义[(47±9)、(48±9)ms比(38±6)ms,均P＜0.05].用药后,观察组QT离散度[(33±9)ms]和校正T峰末间期[(79±6)ms]均明显短于用药前(均P＜0.05),并明显短于对照组[分别为(46±8)、(97±6)ms,均P＜0.05].SAP组QT离散度[(31±6)ms]和校正T峰间期[(78±5)ms]与用药前比较差异无统计学意义(均P＞0.05).结论 陈旧性心肌梗死患者QT离散度及T峰末间期延长,此类患者应用阿托伐他汀钙可减少QT离散度及T峰末间期变化.%Objective To study the contribution of atorvastatin on QT dispersion(QTd) and Tp-e in patients with old myocardial infarction(MI). Methods Fifty-five consecutive patients with old MI were studied(study group): 36 males and 19 females with an mean age of (57±20) years. Patients in study group received atorvastatin 20-40 mg/d≥3 months. Fifty-five cases of old MI without statin were enrolled as a control group. Thirty patients with stable angina pectoris(SAP group) were as SAP group; patients in this group also received atorvastatin 20-40 mg/d≥3 months. QTd and Tp-e were measured and compared as based line and after receiving atorvastatin ≥3 months. Results After receiving atorvastatin ≥3 months, QTd and Tp-e were obviously shorten in study group compared with those in control group[(33±9)ms vs (46±8)ms,(79±6)ms vs (97±6)ms, P<0.05]; QTd and Tp-e were obviously shorten in study group and SAP group compared with based line[study group were (33±9)ms vs (47±9)ms,(79±6)ms vs (100±6)ms; SAP group were(78±5)ms vs (86±6)ms,(31±6)ms vs (38±6)ms]. Conclusion QTd and Tp-e prolong significantly in patients with old MI; QTd and Tp-e can be shortened after receiving atorvastatin in these patients.
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