卡维地洛对急性心肌梗死QT离散度的影响

目的: 探讨卡维地洛对急性心肌梗死不同时期QT离散度(QTd)的影响及与心脏事件的关系。方法: 43例AMI患者分为卡维地洛组20例和对照组23例。分别在入院时及入院后1、3、7、14、21日记录静息12导联同步心电图及心电监护和动态心电图,计算QTd并分析其与心脏事件的关系。结果: AMI患者QTd于24h时显著增大,3天开始下降,后下降速度减慢。卡维地洛组QTd于3日后与对照组比较显著降低(P>0.05)。卡维地洛组心脏事件发生率20.0%,低于对照组34.8%,发生心脏事件的最大QTd为(77.19±10.81) ms (P>0.05),显著高于无心脏事件者(58.15±9.71) ms (P<0.01)。结论: AMI早期存在显著QTd增加。卡维地洛可显著降低AMI患者QT离散度。

Influence of carvedilol on the QT dispersion in patients with acute myocardial infarction

Objective: To explore the influence of carvedilol on the QT dispersion(QTd)in patients with acute myocardial infarction(AMI) at different times and its relation to the incidence of cardiac events.Methods: Fourty-three AMI patients were randomly divided into treatment group(23 cases) and control group(20 cases).The electrocardiogram(ECG)and Holter of the two groups were recorded and compared before therapy and at day 1,3,7,14 and 21 after therapy.The relationship between QTD and cardiac event was analyzed.Results: The QTd increased significantly at 24 h in patients with AMI but started to decrease at day 3,and the velocity was low.After 3 days of treatment with carediol,the QTd in the carwediol group decreased obviously compared with that in the control group(P<0.01).The incidence of cardiac events was 20% in the carvediol group while it was 34.8% in the control group(P>0.05).The max QTd of patients(77.19±10.81) with cardiac events was higher than that without cardiac events(58.15±9.71)(P<0.01).Conclusions: QTd increases obviously at the early stage of AMI.Carvediol may significantly lower the QTd of AMI and decrease the incidence of cardiac events.