急性ST段抬高型心肌梗死患者跨壁复极离散度变化及与室性心律失常的关系

目的:探讨急性ST段抬高的心肌梗死患者心室跨壁复极离散度(TDR)的变化和室性心律失常及自主神经功能障碍的关系。方法:急性ST段抬高急性心肌梗死(AMI)且未能接受成功血管再通治疗的患者129例(STEMI组)和正常对照36例(对照组)作为研究对象。比较2组以及STEMI组入院即刻、第2天、第3天校正的跨壁复极离散度值(TDRc);分析STEMI组24h窦性心搏RR间期的标准差(SDNN)值和入院即刻TDRc的相关性;将STEMI患者分为恶性室性心律失常(MVA)组和非MVA组,比较2组入院即刻的TDRc值。结果:(1)STEMI组的TDRc大于正常对照组(P<0.01),而STEMI组上述3个时段的TDRc值差异无统计学意义(P>0.05)。(2)STEMI组TDRc值和SDNN呈负相关(r=-0.258,P<0.05)。(3)MVA组TDRc显著大于非MVA组(P<0.01)。(4)2例AMI患者住院期间死于心室纤颤,且均发生于MVA组。结论:自主神经功能失调参与了ST段抬高的AMI患者跨壁复极离散度扩增的形成。

The Relationship of Transmural Dispersion of Repolarization and Ventricular Arrhythmia in Patients of Acute Myocardial Infarction with ST-Segment Elevation

Objective: To study the relationship of transmural dispersion of repolarization (TDR) and the ventricular arrhythmia or automatic nerve system dysfunction in patients of acute myocardial infarction (AMI) with ST segment elevation (STE).Methods: One hundred and twenty-nine STE-AMI patients,who were not capable being revascularized (AMI group) and 36 cases of control (control group) were enrolled randomly.The values corrected TDR were compared at the time point of in-charged,the 2nd day and the 3th day betwee...