急性心肌梗塞QT离散度变化及溶栓治疗的影响

目的：分析急性心肌梗塞（ＡＭＩ）患者早期ＱＴ离散度（ＱＴｄ）及溶栓治疗前后ＱＴｄ，ＱＴｃｄ的变化，探讨其在ＡＭＩ时室性心律失常预测及溶栓疗疗评定中意义。方法：测量９８例ＡＭＩ患者常规１２导联心电图ＱＴ间期及其中４０例经溶栓治疗者溶栓前后ＱＴ间期，计算其ＱＴｄ及校正后的ＱＴ离散度，并设正常对照组。

Changes of QT Dispersion in Patients with Acute Myocardial Infarction and Effects of Thrombolytic Therapy

To analyse the changs of QT dispersion(QTd) in patients with acute myocardial infartion(AMI)before and after thrombolytic therapy, and its significance to predict ventri -cular arrhythmias and to assess ef-fects of thrombolytic therapy in patients with AMI.Methods QT dispersion (QTd) and corrected QT dispersion (QTcd)in 98 patients with AMI and 40 Patients with before and after thrombolyfic therapy in them were measured from the 12lead ECG, with 100 cases of healthy people as control group.Results(1) QTd and QTcd of groups with AMI were verylarger than control group (P< 0.001); (2) QTd and QTcd of the ventricular arrhythmias were evidently larger thannon-arrhythmias (P<0.001), and related to degree of anhyhhaas. (3) QTd and QTcd in Patients wyth AMI wererealted to area of infaretion, its subsequence of degree was coplex wall MI>extensive anterior MI> anterior MI>ante-riorseptal MI > inferior MI. (4) It was found that QTd and QTcd were shortted in 24 patients with successful thrombolyt-ic therapy at 2h,24h,3d and 1W later (P<0.05). But QTd and QTd showed no significant change in 16 Patientswith unsuccessful thrombolytic therapy (P<0.001).The differences of QTd and QTcd between successful and unsue- cessful patients at 15min,2h,24h,3d and 1W later were significant(P<0.05 ). Conclusions The increasc of QTd andQTcd may be a mark of susceptibility to serious ventricular arrhythmia in patients with AMI and may be a pledict stau-dard of ventricular arrhythmia.The decrease of after thrombolytic therapy may indicate a srccessful repefusion in patients with AMI.