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

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 2 7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 .0 1 ) ,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 .0 1 ) ,以后 2 4小时内相对稳定。对照组入院后 2 4小时内 QTd、 QTcd变化不大 (P>0 .0 5 )。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

Effect of PTCA on QT Interval Dispersion in AMI.

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.