急性心肌梗死治疗前后QTd QTcd的演变及临床意义

Changes of Acute Myocardial Infarction(AMI) QTd and QTcd Between Pre-and Post-treatment and Their Clinical Significance

目的 观察162例急性心肌梗死（AMI）病人治疗前后4周QTd、QTcd的演变。方法 162例AMI病人分成静脉溶栓再通组、静脉溶栓未通组及未溶栓组，在溶栓前及溶栓后2、12、24h、2～7d、14d、21d、28d同步记录12导联心电图，测量QTd、QTcd进行对照。结果 AMI静脉溶栓再通组与静脉溶栓未通组及未溶栓组QTd、QTcd有极显著性差异（P〈0．001），静脉溶栓未通组及未溶栓组QTd及QTcd无显著性差异（P〉0．05）；3组间恶性室性心律失常的发生率分别为17．4％、56．3％和81．6％。结论 成功的静脉溶栓再灌注可使QTd、QTcd显著降低，并减少恶性室性心律失常的发生。

Objective Changes of 162 AMI patients QTd,QTed between pre- and post- treatment in 4weeks were observed. Methods 162 AMI patients were divided into intravenous thrombolysis recanaization, non- intravenous thrombolysis recanalization and non- intravenous thrombolysis groups. Comparing with QTd,QTed that were measured by ECG before thrombolysis and after thrombolysis 2 - hour,12 - hour,24 - hour,2 ～ 7 day,14 day,21 day,2.8 day. Results QTd,QTcd were significantly prolonged in patients with intravenous thrombolysis recanalization,non- intravenous thrombolysis recanalization and non- intravenous thrombolysis（ P 〈 0.001）. There was no significance different in QTd,QTcd between non - intravenous thrombolysis recanalization and non - intravenous thrombolysis（ P 〉 0.05）. The positive rate of three groups ventricular arrhythmia were 17.4% ,56.3% and 81 .6%. Conclusion Successful early repeffusion of AMI is associated with the reduction of QTd,QTed and the decreased risk of ventricular arrhythmia and risk eardial events.