肥厚型心肌病QT离散度的临床意义及卡维地洛对其作用

目的探讨肥厚型心肌病QT离散度的临床意义及卡维地洛对其的作用。方法入选48例患者，根据超声结果将患者分梗阻性20例（梗阻组）争非梗阻28例（非梗阻组），正常对照组20例。为每个患者记录体表常规12导联同步心电图，分别计算QT、QT离散度（QTd）、校正的QT离散度（QTcd）。在治疗过程中给予卡维地洛，在给药前、1个月和3个月后复查以上指标。结果梗阻性肥厚型心肌病和非梗阻性肥厚型心肌病QT、QTd、QTcd均超过正常值（P〈0.01）；卡维地洛能明显缩短两组的QTd，且梗阻组QTd的变化程度较非梗阻组更显著，用药前（84.2±27.1）ms vs（46.5±20.7）ms，用药3个月后（49.8±19.2）ms vs（41.3±16.3）ms（P〈0.05或〈0.01）。结论两组肥厚型心肌病QT、QTd、QTcd均超过正常值，卡维地洛能明显缩短两组的QTd，且梗阻组QTd的变化程度较非梗阻组更显著，有利于改善患者预后。

QTd of hypertrophic cardiomyopathy and effect of carvedilol

Objective To study the changes of dispersion of QT in hypertrophic cardiomyopathy patients and the effects of carvedilol. Methods Forty-eight patients with hypertrophic cardiomyopathy were divided into two groups,20 cases in obstructive cardiomyopathy group and 28 cases in non-obstructive cardiomyopathy group. Both were created with carvedilol. QT,QT dispersion（QTd）, QT corrected dispersioni（QTcd） were measured before treatment, 1 month and 3 months after treatment. Results QTd of hypertrophic cardiomyopathy was longer than that in control group. QTd in obstructive cardiomyopathy group was much longer than that in non-obstructive cardiomyopathy group before treatment（84.2±27.1） ms vs （46.5±20.7） ms, P〈0.05）;QTd was shortened after 3-month＇s treatment with carvedilol, （49.8±19.2） ms vs （41.3±16.3） ms （P 〈0.01）. Conclusion QTd of hypertrophic cardiomyopathy patients is longer. The treatment with carvedilol can make QTd shorter and may prevent ventricular arrhythmia.