直接经皮腔内冠状动脉成形术对急性心肌梗塞QT离散度的影响

摘要

Objective To study the effect of PTCA on QT interval dispersion(QTd) in acute myocardial infarction(AMI).Methods95 patients with AMI were divided into PTCA group(n=68) and no-PTCA group (control group n=27).QTd and correct QTd(QTcd) were measured in different times.Results In PTCA group,QTd and QTcd were prolonged significantly ［(88.5±24.3)ms vs (63.7±14.9)ms,(92.1±26.8)ms vs(69.3±17.4)ms,P＜0.01］ when coronary artery reopened instantly as compared with those before coronary artery reopened.After 2hs,they returned to the level with these when patients came into the hospital and were decreased significantly(P＜0.01) after 4hs,and then keeped stable in 24hs.In no-PTCA group,QTd and QTcd had no significant changes (P＞0.05)in 24h after patients who were in the hospital.Conclusions Effective treatment with PTCA can be decreased QTd in patients of AMI,but can be prolonged QTd at the instant of reperfusion.%目的研究急性心肌梗塞(AMI)患者应用直接经皮腔内冠状动脉成形术(PTCA)对QT离散度(QTd)的影响。方法回顾95例AMI患者，通过测量入院时及入院后不同时间心电图，计算校正QTd(QTcd)。对比分析其中68例PTCA再通患者(PTCA组)与27例未行PTCA或溶栓患者(对照组)不同时间QTd与QTcd的变化。结果 PTCA组再通即刻QTd、QTcd较再通前明显延长(P＜0.01)，2小时后恢复到入院时水平，4小时后较入院时明显缩短(P＜0.01)，以后24小时内相对稳定。对照组入院后24小时内QTd、QTcd变化不大(P＞0.05)。结论 AMI患者应用成功的PTCA治疗可以缩短心室复极的QTd，但再灌注即刻可加重心室复极的QTd。