急性心肌梗死恢复期介入治疗对QT离散度的影响

Effects of interventional therapy in the recovery period for acute myocardial infarction on QT dispersion

目的探讨急性心肌梗死(AMI)恢复期(2～4周)介入治疗对QT离散度(QTd)的影响。方法选定76例AMI恢复期患者,对照分析行经皮冠状动脉腔内成形术(PTCA)及冠状动脉内支架置入术术前1d和术后1h的标准12导联同步心电图,测量QTd及校正的QT离散度(QTcd),并与53例同期行冠状动脉造影结果正常者(对照组)进行比较。结果AMI组介入治疗术前最大QT间期(QTmax)、最大校正QT间期(QTcmax)、QTd及QTcd均较对照组明显增大,差异具有统计学意义(P<0.01);介入手术后QTmax、QTcmax、QTd及QTcd比术前明显降低,差异具有统计学意义(P<0.01)。而单独进行冠脉造影对QT离散度无明显影响。结论AMI患者QTd和QTcd明显高于正常人,而AMI恢复期介入治疗可使QTd和QTcd显著降低,从而降低急性心肌梗死后恶性心律失常和心源性猝死的发生率,改善AMI患者的预后。

Objective To explore the effects of QT dispersion(QTd) after Interventional therapy during the recovery period(2-4 weeks) for patients with acute myocardial infarction(AMI). Methods To analyze contrastively the changes of QT dispersion 76 AMI patients who underwent intracoronary stenting or percutaneous transluminal coronary angioplasty(PTCA) and 53 normal coronaryy artery subjects. QTd and corrected QT dispersion(QTcd) were measured using 12-lead electrocardiography within 1 d before and 1 h after Interventional therapy and coronary angiography. Results QTmax, QTcmax, QTd and QTcd before Interventional therapy were significantly prolonged in patients with AMI compared with contrast group, with significant difference, P<0.01; QTmax, QTcmax, QTd and QTcd after Interventional therapy were significantly decreased, with significant difference, P<0.01; There was no effects for only coronary angiography. Conclusion QTd and QTcd are significantly prolonged in patients with AMI compared with normal. QTd and QTcd after Interventional therapy are significantly decreased during the recovery period in patients with AMI. Which shows that it can produce beneficial effects in decreasing the risk of ventricular arrhythmia and reducing mortality in AMI patients.