急性心肌梗死治疗前后QTd QTcd的演变及临床意义

目的观察162例急性心肌梗死(AMI)病人治疗前后4周QTd、QTcd的演变。方法162例AMI病人分成静脉溶栓再通组、静脉溶栓未通组及未溶栓组,在溶栓前及溶栓后2、12、24 h、2~7 d、14 d、21 d、28d同步记录12导联心电图,测量QTd、QTcd进行对照。结果AMI静脉溶栓再通组与静脉溶栓未通组及未溶栓组QTd、QTcd有极显著性差异(P<0.001),静脉溶栓未通组及未溶栓组QTd及QTcd无显著性差异(P>0.05);3组间恶性室性心律失常的发生率分别为17.4%、56.3%和81.6%。结论成功的静脉溶栓再灌注可使QTd、QTcd显著降低,并减少恶性室性心律失常的发生。

Changes of Acute Myocardial Infarction (AMI) QTd and QTcd Between Pre-and Post-treatment and Their Clinical Significance

Objective Changes of 162 AMI patients QTd、QTcd between pre-and post-treatment in 4weeks were observed.Methods 162AMI patients were divided into intravenous thrombolysis recanaization、non-intravenous thrombolysis recanalization and non-intravenousthrombolysis groups.Comparing with QTd、QTcdthat were measured by ECGbefore thrombolysis and afterthrombolysis 2-hour、12-hour、24-hour、2 ~7 day、14 day、21 day、28 day.Results QTd、QTcd were significantly prolongedin patients withintravenous thrombolysis recanal-ization、non-intravenous thrombolysis recanalization and non-intravenous thrombolysis(P<0.001).There was no significance different inQTd、QTcd between non-intravenous thrombolysis recanalization and non-intravenous thrombolysis(P>0.05).The positive rate of threegroups ventricular arrhythmia were 17.4 %、56.3 %and 81.6 %.Conclusion Successful early reperfusion of AMI is associated withthe re-duction of QTd、QTcd andthe decreased risk of ventricular arrhythmia and risk cardial events.