急性心肌梗死患者经皮冠状动脉介入治疗对QT离散度的影响

目的 探讨经皮冠状动脉介入治疗对急性心肌梗死QT离散度的影响及其临床意义。方法 回顾性分析资料较完整的急性心肌梗死紧急冠脉介入治疗患者138例,测算术前和术后第1天心电图QT间期、QT离散度、心率校正QT间期和心率校正QT离散度。病例分心肌梗死发病6 h内(72例)和6 h以上(66例)两组。结果 两组QT间期和心率校正QT间期术后与术前相比均无显著性差异,但术后QT离散度和心率校正QT离散度较术前显著减小(P<0.01),且发病6 h内组显著小于发病6 h以上组(P<0.05);两组住院期间死亡率分别为4.2%和7.6%(P=0.394)。结论 成功的介入治疗能显著减小心肌梗死患者的QT离散度,介入治疗施行越早则减小QT离散度的效果越好。

Effect of percutaneous coronary intervention on QT dispersion and its clinical implication in patients with acute myocardial infarction

Objective To observe the effects of percutaneous coronary intervention (PCI) on QT dispersion (QTd) and explore its clinical significance in patients with acute myocardial infarction (AMI). Methods The electrocardiograms recorded before and one day after PCI were analyzed in 138 patients with AMI. The duration from the onset of AMI to PCI operation was less than 6 h in 72 patients and 6 to 12 h in the other patients. All the patients underwent emergency percutaneous transluminal coronary angioplasty and subsequent coronary stenting. QT intervals, QTd, and heart rate-corrected QT intervals (QTc) and QTd (QTcd) were measured and calculated. Results In both patient groups receiving PCI with delay shorter and longer than 6 h after AMI, QT and QTc after PCI were not significantly different from that before PCI, but the QTd and QTcd were remarkably decreased after PCI (all the P values <0.01). Moreover, the QTd and QTcd in the patients with delay of PCI less than 6 h were significantly shorter than those in patients the with greater-than-6-hour delay (P<0.05), and the inhospital mortality was 4.2% and 7.6% in the two groups, respectively (P=0.394). Conclusion Successful PCI may notably reduce QTd in the patients with AMI, whose earlier performance usually produces better effects.