急性心肌梗死患者QT离散度的变化及其临床意义

目的观察急性心肌梗死患者QT间期离散度（QTd）的变化,探讨其与心肌梗死患者室性心律失常的关系,以指导临床治疗。方法 55例急性心肌梗死患者（均在发病后24小时内入院）进行心电图的QTd及QTcd测定,比较有室性心律失常组与无心律失常组的QTd、QTcd之间的差异,观察QTd以及QTcd与室性心律失常的关系。结果急性心肌梗死患者有室性心律失常组QTd及QTcd显著高于无室性心律失常组,QTd（101.6±30.5）ms对（53.1±11.6）ms,QTcd（107.7±19.3）ms对（58.5±12.6）ms,经统计学处理,P〈0.01。结论急性心肌梗死患者QTd或QTcd增大时发生室性心律失常的可能性增大,QT离散度可作为心肌梗死患者病情预测的一项无创性指标。

The change and predict value of QT dispersion in patients with acute myocardial infarction

Objective： To observe the change of the QT dispersion in patients with acute myocardial infarction（AMI）,and study the relationship between QT/ QTcd dispersion and ventricular arrhythmia after acute myocardial Infarction.Methods： QTd and QTcd were measured on the first cardiogram in 55 patients（all the patients hospitalized in 24 hours） with acute myocardial infarction.Based on whether the lethal ventricular arrhythmia had happened,55 cases were divided into two groups： Group A（ventricular arrhythmia group） and Group B（non ventricular arrhythmia group）.The differences of QTd and QTcd were compared between the groups,while the relationship between QTd/QTcd and ventricular arrhythmia was studied.Results： QTd and QTcd dispersion in patients with ventricular arrhythmias were significantly higher than those without ventricular arrhythmia group,QTd（101.6±30.5）ms vs（53.1±11.6）ms,P0.01,QTcd（107.7±19.3）ms vs（58.5±12.6）ms,P0.01.Conclusion： QTd dispersion may be associated with ventricular arrhythmia,and can be as a non-invasive prediction index of the ventricular arrhythmia after AMI.