急性心肌梗死时QT间期离散度测定的临床意义

为了研究急性心肌梗死(AMI)时QT间期离散度(QTD)的变化规律及其与临床的关系,对93例AMI病人进行了人院时及第4周的QTD测定,并与80例正常人对照。结果发现:(1)AMI患者人院时及第4周的QTD均明显长于对照组(P<0.01)。(2)单部位与多部位MI患者人院时的QTD无明显差异,但第4周时多部位MI患者的QTD明显大于单部位MI患者(P<0.05)。(3)AMI合并心衰、室速或室颤者QTD均明显长于无合并症者(P<0.05或P<0.01)。(4)心脏性死亡者QTD明显长于存活者(P<0.01)。结论:AMI患者QTD明显延长,提示心肌复极存在明显的不均匀性和心电不稳定性,对预测心脏事件和猝死有重要参考价值。

Clinical Significance of QT Interval Dispersion during Acute Myocardial Infarction

In order to study the clinical significance of QT interval dispersion changes during acute myocardial infarction and its relation to the clinical practice,QT interval dispersion(QTD)was measured in 93 patients with acute myocardial infarction(MI)on admission and 4 weeks later,and compared with 80 normal subjects. The results showed that QTD in patients with MI whether on admission or 4 weeks later was significantly prolonged than that of the control group(P<0.001) ;QTD had no obvious differences between MI of single and multiple lesions on admission,but QTD in patients with multiple Mis was significantly prolonged than patients with single MI lesion 4 weeks after admission; QTD in patients with heart failure, ventricular tachycardia and ventricular fibrillation during MI was obviously prolonged than patients without complications; and QTD in death cases during MI was significantly prolonged than the survived. The results suggested that QTD was obviously prolonged in patients with acute MI and there was obvious imbalance in the repolarization of myocardium and instability of cardiac electrical activity. All these changes were useful in the predicton of cardiac events and sudden death.