冠状动脉介入治疗对冠心病QT离散度的影响

目的:探讨经皮冠状动脉介入治疗对冠心病患者QT间期离散度(QTd)的影响。方法:对268例冠状动脉造影证实冠状动脉管腔狭窄≥75%而成功行支架置入术,术前、术后进行同步12导联心电图检查,测量QTd和校正QT间期离散度(QTcd);同期测量262例仅行冠状动脉造影术的患者术前、术后的QTd和QTcd。结果:冠状动脉造影组:冠状动脉造影后与冠状动脉造影前QTd和QTcd比较无显著性差异(P>0.05)。支架置入术组:支架置入术后与术前的QTd和QTcd比较明显缩短(P<0.01)。亚组分析表明:术前多支血管病变者的QTd及QTcd显著大于单支血管病变者(P<0.01),且治疗后多支血管病的QTd及QTcd的下降程度均较单支血管病变者更加明显(P<0.01)。结论:成功的支架置入术早期即可改善冠心病患者的QTd、QTcd,从而可能预防早期心血管事件的发生。

Effects of percutaneous coronary intervention on QT dispersion in patients with coronary heart disease

Objective:To explore effects of percutaneous coronary intervention on QT dispersion in patients with coronary heart disease.Methods:12-lead ECG was recorded QT dispersion(QTd) and corrected QT interval dispersion were measured before and after operation in 268 patients whose coronary artery stenosis were≥75% showed by coronary angiography,and who were successfully performed coronary stent implantation.QTd and QTcd were measured on each ECG in another 262 patients who only underwent coronary angiography.Results:①Coronary angiography groups:no change of QTd and QTcd were observed in 262 patients(P>0.05) before and after coronary angiography.②Stent implantation groups:QTd and QTcd were significantly reduced after successful stent implantation compared with that before stent implantation(P<0.01).③In subgroups:QTd and QTcd in patients with multi vessel disease were more sensitive to decrease after angioplasty compared with those in patients with single vessel disease(P<0.01).Conclusion:Successful stent implantation can improve QTd and QTcd of coronary heart disease patients in early,and may reduce the occurrence of cardiovascular disease.