早期康复治疗对无并发症急性心肌梗死患者QT间期离散度的影响

目的探讨早期康复治疗对无合并症急性心肌梗死(acute myocardial infarction ,AMI )患者 QT间期离散度( QTd)的影响. 方法 113例研究对象前瞻性随机分为早期康复治疗组(组 1, 54例 )及对照组 (组 2, 59例 ). 2组主要基线资料具可比性.组 1采用早期康复治疗方案,组2采用传统康复方案.所有研究对象分别在入院当时 [平均( 9.3± 1.9) h]第1周末、第 2周末、第 3周末记录标准 12导联心电图. QT 间期的测量从QRS 波起点至 T波终点,同一导联测量 3个心动周期,取其平均值.不同导联最大减去最小QT值为 QTd 值. 结果早期康复组入院当时、第 1 周末、第 2 周末、第 3周末QTd[分别为 (64± 14)ms,(46± 15)ms,(43± 12)ms,(39± 13)ms]与对照组 [分别为 (67±12)ms,(48± 16)ms,(41± 13)ms,(40± 15)ms]比较统计学上无显著性差异( t分别为0.81,0.68,0.85,0.38, P >0.05). 结论无合并症 AMI患者实行早期康复治疗不影响 QTd 值,因而不影响心肌电稳定性,提示该组患者早期康复治疗安全可行.

Effect of earlyrehabilitative intervention on interval QT dispersion of acute myocardial infarctionpatients without complication

AIM: To study the effect of early rehabilitative intervention on interval QT dispersion(QTd)of acute myocardial infarction(AMI) patients without complication. METHODS:One hundred and thirteen subjects were randomly divided into the early rehabilitation therapy group(group 1,n=54) and the control group(group 2,n=59).Baseline data of the patients in the two groups were comparable.Patients in group 1 received early rehabilitative intervention,while patients in group 2 received traditional rehabilitation.12-lead ECG was recorded in all subjects at the time of hospitalization[mean(9.3± 1.9)hours],at the end of the first,second and third week after the onset of AMI.QTd was measured from the initial point of QRS wave to the destination of T wave,three cardiac cycles were measured with the same lead,and the average value was needed.QTd was the value that the maximal QT value subduced the minimal QT value in different leads. RESULTS: There was no significant difference in QTd between the early rehabilitation group and the control group at the time of hospitalization,at the end of one week,two weeks and three week after the onset of AMI[(64± 14)ms,(46± 15)ms,(43± 12)ms,(39± 13)ms,respectively vs(67± 12)ms,(48± 16)ms,(41± 13)ms,(40± 15)ms,respectively]( t=0.81,0.68,0.85,0.38, P > 0.05) . CONCLUSION: QTd is not influenced by early rehabilitative intervention on AMI patients without complication,so the electric stability of myocardium is not influenced.The early rehabilitative intervention to AMI patients without complication is safe and feasible.