急诊静脉溶栓治疗对老年急性心肌梗死QTd和CVA的影响

目的]观察尿激酶溶栓治疗对老年急性心肌梗死（AMI）QT离散度（QTd）和复杂室性心律失常（CVA）的影响。方法]对55例老年AMI患者在发病6h内予以尿激酶溶栓治疗，比较AMI溶栓再通组与溶栓非再通组治疗前后QTd和QT离散度校正值（QTcd）以及两组溶栓前和溶栓治疗后7d内CVA事件发生率。结果]AMI溶栓再通组治疗7d后QTd和QTcd较非再通组显著减少（P〈0．05），非再通组治疗前后QTd、QTed相比较差异无统计学意义（P〉0．05）。再通组CVA事件的发生率亦显著低于溶栓非再通组（P〈0．05），非再通组治疗前后CVA的发生率差异无统计学意义（P〉0．05）。结论]尿激酶溶栓治疗可减小AMI患者的QTd或QTcd，减少CVA的发生；QTd或QTcd可作为观察溶栓和再灌注效果的一个有效指标。

Effect of Thrombolysis with Urokinase on QT Dispersion and CVA in Elderly Patients with Acute Myocardial Infarction

Objective] To investigate the effect of vein thrombolysis with urokinase on QT dispersion （QTd）and complicated ventricular arrhythmia （CVA） in elderly patients with acute myocardial infarction （AMI）. Methods] QTd and QT corrective dispersion （QTcd）of 55 cases with AMI were measured in 6h when the patients were attacked. The changes of QTd and QTcd and the incidence of CVA were compared between effective group and ineffective group. Results] After thrornbolysis was administered for 7 days , QTd and QTcd of the effective group were significantly smaller and the incidence of complicated ventricular arrhythmia（CVA） was lower than those of the ineffective group（ P 〈0. 05）. Conclusion] Urokinase thrombolysis can reduce QTd and QTcd of patients with AMI , and can decrease the incidence of CVA. QTd or QTcd is an effective index to evaluate the therapeutic effect of thrombolysis and reperfusion of acute myocardial infarction patients.