溶栓治疗对急性心肌梗塞患者QTc间期的影响

为探讨溶栓治疗对急性心肌梗塞（ＡＭＩ）患者ＱＴｃ间期的影响，将７０例ＡＭＩ患者随机分为溶栓组（３２例）和未溶栓组（３８例）。两组病人发病后ＱＴｃ间期平均值均延长，两者比较无显著性差异（４５８±５２ｍｓｖｓ４７１±６０ｍｓ，Ｐ＞０．０５）。溶栓后１和３日ＱＴｃ间期明显延长，与未溶栓组入院后１和３日ＱＴｃ间期比较存在显著性差异（分别为４８８±５１ｍｓｖｓ４５５±５２ｍｓ，４８０±５４ｍｓｖｓ４５５±４４ｍｓ，Ｐ均＜０．０５），这种变化可能与溶栓后的缺血再灌注损伤有关。入院后７日两组ＱＴｃ间期比较无统计学差异（４４６±５６ｍｓｖｓ４５２±４１ｍｓ，Ｐ＞０．０５）。溶栓组入院后第１，３，７日与入院时ＱＴｃ间期平均值之差值分别为－（２９±１０），－（６±９），１０±８ｍｓ，未溶栓组则为１６±８，９±１０，１９±９ｍｓ，两组比较有显著性差异（Ｐ＜０．０５或＜０．０１）。因此比较ＱＴｃ间期缩短的速度比单纯比较ＱＴｃ间期对于判定溶栓治疗的疗效可能更有意义

Influence of Thrombolysis on QTc Interval of Acute Myocardial Infarction

Seventy patients of acute myocardial infarction(AMI) were divided into two groups.32 cases were treated with thrombolysis(group 1) and 38 cases were not (group 2).QTc interval prolongation happened in both groups,no statistic difference between them before treatment.In group I,QTc interval prolonged within the 1st and 3rd day after thrombolysis,compared with group 2,there had statistic difference (488±51 ms vs 455±52 ms and 480±54 ms vs 455±44 ms, P <0.05 respectively).This may be related with reperfusion of ischemia.In group 1,the decending values or QTc interval during 1,3,7 days were -(29±10),-(6±9),10±8 ms respectively,and In group 2,were 16±8,9±10,19±9 ms.The changes of QTc interval between two groups were significantly different statistically( P <0.05 or P <0.01).The results suggest that comparing the decending speed of QTc interval could be more effective than QTc interval comparision as to deciding the curative effects of AMIs thrombolysis.