急性心肌梗死患者美托洛尔干预前后QT离散度的变化

目的 探讨急性心肌梗死(AMI)患者美托洛尔(Metoprolol)干预前后QT离散度(QTd)的变化。方法 74例AMI患者分基础治疗 美托洛尔治疗组(A组,37例)和基础治疗组(B组,37例),并对治疗前和治疗7天后的QTd进行对比分析。另设正常人组25例(C组)作对照。结果 A、B组患者QTd较C组明显增加(P<0.01),在74例AMI患者中伴室性心律失常者高于无室性心律失常者(P<0.01),前壁心肌梗死与下后壁心肌梗死间QTd差异无显著性(P<0.05)。治疗7天后A、B两组的QTd均较治疗前明显降低(P均<0.01),但A组较B组下降更为明显,两组间有显著性差异(P<0.01) 结论 AMI患者早期QTd增加,并且与室性心律失常的发生有关,与梗死部位无关。美托洛尔可降低AMI早期QTd。

Changes of QT Dispersion in Patients With Acute Myocardial Infarction Before and After Interference by Metoprolol

Objective To explore the changes of QT dispersion (QTd)in patients with acute myocardial infarction (AMI) before and after interference by metoprolol. Methods Seventy four patients with AMI were randomized into metoprolol treat-ment group (conventional treatment metoprolol, A group,n = 37)and conventional treatment group(B group,n= 37) .normal group(C group,n = 25)as control. Results QTd was significantly increased in patients with AMI as compared with controls(P< 0. 01). It was significantly increased in patients with ventricalar arrhytnmia in comparing with those without ventricular arrhythmia (P<0. 01). There was no significant difference in QTd between anterior and interior-posterior AMI. QTd was significantly decreased in group A and B after 7days of treatment,but it decreased more significantly in group A than group B(P<0. 01). Conclusions QTd was significantly increased in patients with early AMI. It is associated with the occurence of ventricular arrhythmia. It is not associated with the section of AMI. Metoprolol can decrease the QTd in patients with early AMI. The re-suits indicated one of the mechanisms of beta-blockers decrease the mortality in patients with early AMI. It plays a very important role in AMI.