急性心肌梗死急诊经皮冠状动脉介入治疗对QT离散度的影响

目的观察急诊经皮冠状动脉介入（percutaneous coronary intervention，PCI）治疗对急性心肌梗死患者QT离散度（QT dispersion，QTd）的影响，以期寻找评价急诊PCI治疗预后的有效无创方法。方法将2011年02月至2012年05月在北海市人民医院行急诊PCI治疗的53例急性心肌梗死患者设为急诊PCI治疗组；将同期冠状动脉造影提示冠状动脉狭窄程度≥50％并〈75％的58例患者设为单纯药物治疗组；另外，选择同期冠状动脉造影提示冠状动脉狭窄程度〈50％的143例患者设为对照组。急诊PCI治疗组所有患者均在PCI治疗前、治疗后3d、术后1周分别检测QTd；单纯药物治疗组及对照组在入院时、治疗后3d及1周分别检测QTd。结果急诊PCI治疗组PCI治疗后3d、1周QTd值与术前比较均明显缩小，差异有统计学意义（P〈0．01），术后3d的QTd与对照组比较，差异无统计学意义（P〉0．05）。单纯药物治疗组药物治疗后1周QTd明显改善，与治疗前比较差异有统计学意义（P〈0．05），但与对照组比较差异仍有统计学意义（P〈0．05）。急诊PCI治疗组与单纯药物治疗组比较，QTd下降幅度较大，两组3d、1周QTd值差异有统计学意义（P〈0．05）。结论急诊PCI治疗可使急性心肌梗死患者的QTd快速、显著缩短，从而减少主要心血管事件的发生。

Effect of percutaneous coronary intervention on QT dispersion in patients with acute myocardial infarction

Objectives To explore the effect of primary percutaneous coronary intervention （P-PCI） on QT dispersion in patients with acute myocardial infarction and explore a noninvasive, effective method for prognostic evaluation. Methods Totally 53 patients undergoing P-PCI in the People＇s Hospital of Beihai from February 2011 to May 2012 were determined as P-PCI group and other 58 patients with 50% to 75% angiographic stenosis were determined as drug treatment group. Another 143 individuals with less than 50% angiographic stenosis were recruited as control group. All the patients in P-PCI group received evaluation of QT dispersion before PCI, 3 days and 1 week after PCI. QT dispersion of drug treatment and control groups was evaluated on admission, 3 days and 1 week after treatment. Results The QT dispersion decreased obviously 3 days and 1 week after PCI than before PCI in P-PCI group （all P〈0.01）. Compared to that before treatment,the QT dispersion improved significantly 1 week after treatment in drug treatment group （all P〈0.05）. Compared to drug treatment group, the treatment of P-PCI led to markedly lower QT dispersion at 3 days and 1 week in P-PCI group （all P〈0.05）. Conclusions There is a rapid and significant decrease in QT dispersion and reduction of major cardiac evens in patients with acute myocardial infarction undergoing P-PCI.