老年冠心病患者QT离散度变化及其临床意义

目的探讨老年冠心病患者ＱＴ离散度（ＱＴｄ）和心率校正的ＱＴ离散度（ＱＴｃｄ）与致命性室性心律失常（ＦＶＡ）及心衰（ＨＦ）之间的关系。方法测定了８４例老年冠心病患者的ＱＴｄ及ＱＴｃｄ，其中心原性猝死（ＣＳＤ）９例，ＦＶＡ２３例，非ＦＶＡ６１例。有ＨＦ４７例，无ＨＦ３７例。结果ＣＳＤ组ＱＴｄ、ＱＴｃｄ显著大于ＦＶＡ及非ＦＶＡ组（Ｐ＜０．０５；Ｐ＜０．０１），ＦＶＡ组ＱＴｄ、ＱＴｃｄ大于非ＦＶＡ组（Ｐ＜０．０１），ＨＦ组ＱＴｄ、ＱＴｃｄ显著长于无ＨＦ组（Ｐ＜０．０１）。本文ＱＴｄ和ＱＴｃｄ呈显著正相关（ｒ＝０．９７２０，Ｐ＜０．０１）。结论作者认为ＱＴｄ和（或）ＱＴｃｄ可作为评估老年冠心病患者发生ＦＶＡ和（或）ＨＦ预后的重要参考指标。

Changes and clinical significance of QT dispersion in the elderly with coronary heart disease

Objective In this study the relation of QT dispersion(QTd)and QTd corrected with R R interval(QTcd)in fatal ventricular arrhythmia (FVA)and herat failure (HF)cases in elderly coronar heart disease patients was analyzed.Methods The authors measured the QTd and QTcd in 84 elderly cases with coronary heart disease.There were 9 cases with cardiac sudden death(CSD),23 cases with FVA and 61 cases with non FVA(NFVA) Of all the patients,47 cases presented heart failure(HF)while 37 cases did not (NHF) Results The results showed that QTd and QTcd were longer in the CSD group than in the FVA and NFVA groups( P <0 05 and P <0 01 respectively) QTd and QTcd were greater in HF group than in NHF group( P <0 01).The paper showed a significant positive correlation between the QTd and QTcd( r =0 9720, P <0 01).Conclusions The author suggests that QTd and/or QTcd may have a significant prediction value in the prognosis of the occurrence of FVA and /or HF in the elderly with coronary heart disease.