AMI患者QT离散度与急诊PCI及梗死面积研究

目的:研究AMI患者心电图QTd与急诊PCI及梗死面积的相关性。方法:回顾性比较住院期间AMI患者180例,将其中60例行急诊PCI者与60例未行介入治疗者进行对照,观察术前与术后相关血管恢复有效灌注后QTd、QTcd的变化,120例未经急诊PCI的AMI患者QTd、QTcd与CK峰估计的心肌梗死面积的关系。结果:AMI患者行急诊PCI再灌注治疗组术后第1、2、3天及1周时QTd、QTcd较未行再灌注治疗的AMI对照组同期QTd、QTcd明显缩短。经急诊PCI治疗组术后第1天QTd、QTcd较术前无显著差异,术后第2、3天及1周时QTd、QTcd较术前缩短。AMI患者CK峰估计的心梗面积与QTd、QTcd呈正相关性。结论:QTd作为一种简单非侵入的方法对评价早期再灌注疗效有一定价值,对估计心肌梗死面积并评价心梗预后有重要的参考价值。

The study of relations between QT dispersion of AMI patients and emergency percutaneous coronary intervention and the infarction size

Objective To study the relations between QT dispersion of acute myocardial infarction(AMI) patients' electrocardiograms and emergency percutaneous coronary intervention(PCI) and the infarction size. Method 180 patients of AMI were studied retrospectively. 60 patients who underwent emergency PCI were compared with 60 patients unaccepted emergency PCI, in order to evaluate the differences of QTd or QTcd before and after interventional therapy. The relation between QTd or QTcd of 120 patients who unaccepted emergency PCI and the infarction size which was estimated by the peak creatine phosphokinase was forecasted. Results QTd or QTcd(1d, 2d, 3d and 1w) in patients who acceped emergency PTCA was significantly shorter than that in the controls who unaccepted emergency PTCA. The data of patients who accepted emergency PTCA showed that QTd or QTcd on 1st day after interventional therapy wasn't obviously different from that of preoperative, but on 2nd day, 3rd day and 1st week after emergency PTCA was obviously shorter than that of preoperative. There were significantly positive correlations between QTd or QTcd and the infarction size while was evaluated by peak creatine phosphokinase levels. Conclusion QT dispersion acts as a simple and none intruding method to evaluate the effect of early reperfusion of AMI is valuable. QTd or QTcd has important referred value in estimating the infarction size and evaluating prognosis of AMI.