校正QT间期在急性ST段抬高心肌梗死中的变化特点及临床意义

目的探讨校正QT(QTc)间期在急性ST段抬高心肌梗死(STEMI)患者中的变化特点及临床意义。方法选择急性STEMI患者170例作为试验组,另选健康体检者200例作为对照组。试验组患者均接受急诊PCI,观察患者发病后30、60及120 min和PCI前后的QTc间期变化特点,并根据发病30 min后QTc间期长度,分为延长组56例、缩短组16例和正常组98例3个亚组。对2组临床资料进行分析。结果与对照组比较,试验组QTc间期延长及QTc间期缩短患者发生率高(P<0.01)。与正常组比较,延长组心肌梗死发生在前壁和(或)高侧壁的比例高,罪犯血管为前降支的比例高(P<0.05);缩短组心肌梗死多发生在下壁和(或)后壁的比例相近,差异无统计学意义(P>0.05),罪犯血管为前降支的比例高(P<0.05)。与正常组比较,延长组及缩短组出现心功能Killip≥Ⅲ级的比例高,差异有统计学意义(P<0.05)。结论 QTc间期延长或缩短可能是STEMI患者不良心血管事件新的预测因素,并对患者预后的评估有一定指导意义。

Characteristics and clinical significance of corrected QT interval in acute ST-segment elevation myocardial infarction

Objective To study the characteristics and clinical significance of corrected QT interval in acute ST-segment elevation myocardial infarction(STEMI).Methods One hundred and seventy acute STEMI patients served as experimental group and 200 healthy subjects served as control group.Patients in experimental group were treated with emergency PCI and characteristics of QTc interval were observed 30,60,120 min after the onset of disease,and before and after PCI. The patients were divided into prolonged QTc interval group(n = 56 ),shortened QTc interval group(n= 16),and normal QTc interval group(n= 98) which was further divided into 3 subgroups, and their clinical data were analyzed.Results The incidence of prolonged and shortened QTc interval was higher in experimental group than in control group(P<0.05).The incidence of myocardial infarction at anterior wall and/or high lateral wall was higher in prolonged QTc interval group and at the anterior descending artery in criminals than in normal QTc interval group (P<0.05).The incidence of myocardial infarction at inferior wall and/or posterior wall was similar in shortened QTc interval group(P>0.05) and higher at the anterior descending artery in criminals(P<0.05).The incidence of myocardial infarction was higher in prolonged and shortened QTc interval groups than in normal QTc interval group when the Killip was≥Ⅲ(P < 0.05).Conclusion Prolonged or shortened QTc interval is a new predictor for adverse cardiovascular events in STEMI patients and their prognosis.