缬沙坦对急性心肌梗死患者早期QT间期离散度的影响

通过研究缬沙坦对急性心肌梗死 (AMI)患者早期QT间期离散度 (QTd)的影响 ,探讨缬沙坦对缺血心肌的保护作用。将 34例AMI患者随机分成缬沙坦 +基础治疗组 (治疗组 ,A组 ,17例 )和基础治疗组 (对照组 ,B组 ,17例 )。另设正常人 2 0例作对照组 (正常对照组 ,C组 )。在服药前、服药后 3,7天分别测量QTd及校正的QTd(QTcd) ,并观察服药前及服药 3天后室性心律失常的发生率。结果 :AMI患者的QTd及QTcd较正常人明显延长 (75 .9± 11.9vs 32 .7± 12 .6ms ,85 .5± 12 .8vs 36 .5± 13.2ms,P均 <0 .0 1) ;AMI患者中发生室性心律失常者 (19例 )的QTd及QTcd则较非室性心律失常者 (15例 )明显增加 (81.1± 11.1vs 6 9.3± 9.6ms,92 .0± 10 .5vs 73.6± 18.9ms ,P均 <0 .0 1) ;服药 7天后A组和B组的QTd及QTcd均明显减少 ,但A组比B组减少的更为显著 (41.5± 11.1vs 5 7.9± 10 .8ms,4 6 .9± 12 .3vs 6 5 .5± 12 .5ms ,P均 <0 .0 1) ;服药 3天后A组的QTd及QTcd较服药前也有明显的减少 ;服药 3天后A组中发生室性心律失常者 (2例 )明显减少 ,与治疗前 (10例 )有显著性差异 (P <0 .0 5 )。结论 :AMI患者早期QTd及QTcd较正常人增大 ,并且伴有室性心律失常的患者QTd及QTcd增大更为显著 ,AMI患者早期服用缬沙坦可降低QTd及

The Effect of Valsartan on QT Dispersion in Patients With Acute Myocardial Infarction

To explore protective action of Valsartan on ischemic myocardium by studying the impact of Valsartan on QT dispersion (QTd) in patients with acute myocardial infarction (AMI),34 AMI patients were randomized divided into conventional treatment+Valsartan treatment group (A group, n =17) and conventional treatment group (B group, n =17).QTd and QT corrected dispersion (QTcd) were measured based on the electrocardiogram from the beginning and 3 days,7 days after taking medicine.Normal group (C group, n =20) was regard as control.Then the QTd,QTcd and ventricular arrhythmia of the two groups were compared.Results:QTd and QTcd increased significantly in patients with AMI compared with controls(75.9±11.9 vs 32.7±12.6 ms,85.5±12.8 vs 36.5±13.2 ms, P <0.01).They increased significantly in patients with ventricular arrhythmia compared with those without ventricular arrhythmia(81.1±11.1 vs 69.3±9.6 ms,92.0±10.5 vs 73.6±18.9 ms, P <0.01).QTd and QTcd were decreased obviously in group A and group B after 7 days of treatment,but they were decreased more obviously in group A than group B(41.5±11.1 vs 57.9±10.8 ms,46.9±12.3 vs 65.5±12.5 ms, P <0.01).Ventricular arrhythmia rate was decresed after 3 days of treatment compared with the rate before treatment(2 vs 10, P <0.05).Conclusions:QTd and QTcd increased apparently in patients with AMI.They increased more significantly in patients with ventricular arrhythmia.Valsartan can improve the recent prognosis by decreasing QTd and ventricular arrhythmia.