经皮冠状动脉腔内成形术对心绞痛和心肌梗塞QT离散度的影响及其临床意义

目的：探讨经皮冠状动脉内成形术（ＰＴＣＡ）对心绞痛和心肌梗塞病人ＱＴ离散度（ＱＴｄ）的影响及其意义。方法：分析８４例心绞痛和心肌梗塞患者ＰＴＣＡ术前、术后一天内所记录的心电图，测算ＱＴ间期、ＱＴ离散度、心率校正ＱＴ离散度（ＱＴｃｄ）。病例分为三组：心绞痛ＰＴＣＡ成功组、心肌梗塞ＰＴＣＡ成功组、心肌梗塞ＰＴＣＡ失败组。分别对三组ＱＴｄ、ＱＴｃｄ作术前、术后比较。结果：前二组术后ＱＴｄ、ＱＴｃｄ较术前显著减少（Ｐ＜０．０１），失败组术前、术后ＱＴｄ及ＱＴｃｄ差异无显著性（Ｐ＞０．０５）。结论：成功的ＰＴＣＡ能显著减少心绞痛和心肌梗塞患者的ＱＴｄ，提示可能减少心律失常的发生率，从而减少心肌缺血患者的死亡率，可以改善患者的预后，术后心肌梗塞患者ＱＴｄ减少可能反映了顿抑或冬眠心肌的“苏醒“，并表明梗塞区内尚有存活心肌。

The Effects of Percutaneous Transluminal Coronary Angioplasty on QT Dispersion of Angira Pectoris and Myocardial Infarction Patients and Finding out Their Significanies

Objective:To evaluate the effecfs of percutaneous transluminal coronary angioplasty(PTCA) on QT dispersion(QTd) and finding out their significances.Methods:The electrocardiograms recorded before and after PTCA in 84 patients including 34 with angina pectoris(AP) and 50 with myocardial infarction(MI) were analyzed.QT intervals,QTd and heartrate-corrected QT dispersion(QTcd) were gauged and calculated.The comprision of QTd and QTcd before PTCA to those after PTCA were made respectively in 3 groups(AP PTCA success,MI PTCA success,MI PTCA failure).Result:In the former two groups,QTd and QTcd after PTCA were remarkably reduced(P values<0.01).In PTCA failure group,no changes of the 2 indices were shown after PTCA.Conclusion:Successful PTCA could notably reduce QTd in patients with AP or with MI,Suggesting that it might improve the prognosis of coronary heart disease.The reduction in QTd after PTCA might imply the revivals of the existence of stuned or hibernating myocardium as well as the existence of s