冠心病患者经皮冠状动脉介入术后QTd及HRV的变化

目的]观察冠心病患者经皮冠状动脉介入术（PCI）前后QT离散度（QTd）和心率变异性（HRV）的变化特点与趋势,探讨PCI术对QTd和HRV的影响,从而估计PCI对冠心病患者预后的影响.方法]选择2009年1月至2010年1月入院的经冠状动脉造影证实适合PCI的患者80例,其中单支病变组42例、双支病变组24例及三支病变组14例 ,在术前d3、术后d10、术后1个月分别测QTd、HRV.结果]PCI术前d3（58.59±12.69 ms）]和术后d10（45.64±10.45）、1个月（43.31±9.86）ms]的QTd比较差异有显著性意义（P＜0.01）,而术后d10和术后1个月的QTd比较差异无显著性意义（P＞0.05）.PCI术前d3 HRV 与术后d10相比差异无显著性意义（P＞0.05）、而与术后1个月相比有显著性差异（P＜0.01）;单支病变组术后QTd和HRV改善程度（22.09±2.01） 、 （36.69±5.61） ms]高于双支病变组（18.37±2.25） 、（31.14±4.62）ms]（P＜0.05）,双支病变组QTd和HRV改善程度高于三支病变组（15.16±2.05） 、（26.10±3.36）ms]（P＜0.05）.结论]成功的PCI使缺血的心肌重新获得充足的血供,QTd改善迅速而显著,HRV在术后1月改善显著 ;且PCI术对冠心病患者QTd和HRV的影响与冠状动脉血管病变数目密切相关.

Changes of QT Dispersion and Heart Rate Variability in Patients with Coronary Heart Disease after Percutaneous Coronary Intervention

Objective]To observe the changes and trend of QT dispersion（QTd） and heart rate variability （HRV） in patients with coronary heart disease（CHD） after percutaneous coronary intervention（PCI） in order to explore the effect of PCI on QTd and HRV and further evaluate the influence of PCI on the prognosis of CHD patients. Methods]Eighty patients who were suitable for PCI confirmed by coronary arteriography in our hospital from Jan. 2009 to Jan. 2010 were divided into one-vessel lesion group（ n =42）, two-vessel lesion group（ n =24） and three-vessel lesion group（ n = 14）. QTd and HRV were measured 3 days before PCI, 10 days and a month after PCI. fResults] There was significant difference in QTd among 3 days before, 10 days and a month after PCI（58.59±12.69）ms vs （45.64±10.45）ms vs （43.31±9.86）ms]（ P 〈0.01）, but there was no significant difference between 10 days and a month after PCI（ P 〉0.05）. There was no significant difference in HRV between 3 day before and 10 days after PCI（ P〉 0.05）, but there was significant difference between 3 days before and a month after PCI（ P 〈0.01）. The improvement of QTd and HRV after PCI in one-vessel lesion group（22.09±2.01）ms and （36.69±5.61）ms] were higher than those in two-vessel lesion group（18.37±2.25）ms and （31.14±4.62）ms]（ P 〈0.05）. The improvement of QTd and HRV in two-vessel lesion group were higher than those in three-vessel lesion group（15. 16± 2. 05） and （26. 10± 3.36）ms] （ P d0.05）. Conclusion]Successful PCI can supply enough blood to ischemic myocardium as well as rapidly and obviously improve QTd and HRV in a month after PCI. The effect of PCI on QTd and HRV of CHD patients is closely related to the number of coronary artery lesion.