缬沙坦对急性心肌梗死患者早期QT间期离散度的影响

通过研究缬沙坦对急性心肌梗死 (AMI)患者早期QT间期离散度 (QTd)的影响 ,探讨缬沙坦对缺血心肌的保护作用。将 34例AMI患者随机分成缬沙坦 +基础治疗组 (治疗组 ,A组 ,17例 )和基础治疗组 (对照组 ,B组 ,17例 )。另设正常人 2 0例作对照组 (正常对照组 ,C组 )。在服药前、服药后 3,7天分别测量QTd及校正的QTd(QTcd) ,并观察服药前及服药 3天后室性心律失常的发生率。结果 :AMI患者的QTd及QTcd较正常人明显延长 (75 .9± 11.9vs 32 .7± 12 .6ms ,85 .5± 12 .8vs 36 .5± 13.2ms,P均 <0 .0 1) ;AMI患者中发生室性心律失常者 (19例 )的QTd及QTcd则较非室性心律失常者 (15例 )明显增加 (81.1± 11.1vs 6 9.3± 9.6ms,92 .0± 10 .5vs 73.6± 18.9ms ,P均 <0 .0 1) ;服药 7天后A组和B组的QTd及QTcd均明显减少 ,但A组比B组减少的更为显著 (41.5± 11.1vs 5 7.9± 10 .8ms,4 6 .9± 12 .3vs 6 5 .5± 12 .5ms ,P均 <0 .0 1) ;服药 3天后A组的QTd及QTcd较服药前也有明显的减少 ;服药 3天后A组中发生室性心律失常者 (2例 )明显减少 ,与治疗前 (10例 )有显著性差异 (P <0 .0 5 )。结论 :AMI患者早期QTd及QTcd较正常人增大 ,并且伴有室性心律失常的患者QTd及QTcd增大更为显著 ,AMI患者早期服用缬沙坦可降低QTd及     

冠脉内成形及支架术前后QT离散度的变化

目的　探讨冠脉内成形及支架术对冠心病患者QT离散度的影响。方法　对成功实施了冠脉内成形及支架术的冠心病患者 5 0例 ,记录术前 1天与术后第 1天、第 7天的 12导联心电图 ,计算各QTd、QTcd。结果　冠心病患者冠脉内成形及支架术前 1天、术后第 1天、第 7天QTd和QTcd分别为72 1± 9 3ms和 6 9 5± 8 8ms、5 8 3± 5 2ms和 5 7 4± 5 1ms、4 1 6± 3 6ms和 4 0 2± 3 2ms,术后QTd及QTcd均显著低于术前 (P <0 0 5 )。结论　冠脉内成形及支架术可使冠心病患者QTd明显缩短。     

右心室流出道间隔部起搏的临床观察

目的 比较右心窜流出道间隔部(RVOTS)起搏与右心室心尖部(RVA)起搏对患者心功能的影响.方法 对29例行心脏起搏器植入治疗的Ⅲ°房室传导阻滞患者随机分为RVOTSP组(15例)和RVAP组(14例),观察两组患者手术一般情况,以及术后12个月的心电图、心脏彩超EF值和左心室舒张末期内径等指标变化.结果 两组患者手术时间、心窒电极导线过三尖瓣后的X线曝光时间、术中各项参数的测试结果等比较,差异无统计学意义(P>0.05);术后随访12个月,RVOTSP组QRS波时限、左心窒蕈鼍、NYHA心功能分级和左心室射血分数均优于RVAP组,差异均有统计学意义(P<0.05);术后12个月血浆脑钠肽水平与术前比较,RVOTSP组差异无统计学意义(P>0.05),RVAP组升高(P<0.05).结论 RVOTS起搏较RVA起搏更符合"生理性"起搏的特点,对心功能及心电的不良影响也小于RVA起搏,且安全可靠,能改善患者远期心功能,提高其生存质量.     

卡维地洛对急性心肌梗死病人QT、JT离散度及心率变异性的影响

目的 研究卡维地洛对急性心肌梗死病人QT、JT离散度及心率变异性的影响.方法将115例急性心肌梗死病人随机分为卡维地洛组（65例）与对照组（50例）,两组均予常规治疗,卡维地洛组加用卡维地洛12.5 mg,2次/日,疗程4个月,并随访至半年.检测两组治疗前后QT离散度、JT离散度、心率变异性变化,并记录半年内的不良心血管事件发生情况.结果 经过4个月的治疗,两组QT离散度、JT离散度、心率变异性的时域及频域指标较治疗前均明显改善（P＆lt;0.01）,但卡维地洛组更为明显（P＆lt;0.01）.卡维地洛组半年内不良心血管事件发生率较对照组显著减少（P＆lt;0.05）.结论卡维地洛可显著减小急性心肌梗死病人QT、JT离散度及提高慢性心率变异性,减少心血管不良事件.     

长龙通注射液对纤维蛋白溶解酶活性的影响

长龙通注射液对家兔、豚鼠增加纤维蛋白溶解酶活性,给药后20min,50min时最显著,90min后作用明显减弱或恢复正常,在家兔连续多次给药实验中,测定给药20min时纤维蛋白溶解酶活性显著增加（P＜0．01）,凡给药24h后测定,纤维蛋白溶解酶活性均不见明显增强,说明长龙通注射液中增加纤维蛋白溶解酶活性的有效成分在体内没有蓄 积作用,有效作用时间短。     

QT interval measurement: Q to TApex or Q to TEnd?

OBJECTIVE: To study QT interval. QT interval is frequently measured, though there is variation in the literature as to whether it is more appropriate to measure from the Q wave to the apex of the T wave, which is methodologically easy, or to measure to the end of the T wave. HYPOTHESIS: For Q-TApex interval to be used as a measure of repolarization, the variability of the Q-T interval should lie in this early phase. This should be true in health and in disease, at rest and with physiological interventions such as exercise. If there is variability in the TApex - TEnd interval, this should be reflected by the variability in the Q-TApex interval. METHODS: Fifty-six subjects were recruited: 24 with heart failure, 16 with left ventricular hypertrophy and 16 controls. Q-TApex, Q-TEnd and TApex-TEnd intervals were measured at rest and on exercise. RESULTS: Q-TApex intervals at rest were not different amongst the three groups studied, being 339 +/- 7 ms for controls, 341 +/- 6 ms in left ventricular hypertrophy and 351 +/- 6 ms in heart failure. The Q-TEnd interval at rest was 421 +/- 6 ms in controls, 420 +/- 6 ms in hypertrophy and 461 +/- 9 ms in failure (P < 0.05 for failure versus hypertrophy or control). Thus the TApex-TEnd interval was prolonged in heart failure at rest. However, at peak exercise there was no difference between the TApex-TEnd intervals in the different groups. Variability in the TApex-TEnd interval induced by disease or by exercise was not related to variability in the Q-TApex interval. CONCLUSION: Q-TEnd rather than Q-TApex should be used when Q-T interval measurement is required.