QT离散度对PCI术后冠状动脉再狭窄的临床评估及应用价值研究

The Assessment and Value of QT Dispersion on the Restenosis after Percutaneous Coronary Intervention

目的对经皮冠状动脉介入(PCI)术前、术后有及无再狭窄病人行QT离散度(QTd)分析,评估QTd对PCI术后冠状动脉再狭窄的临床应用价值。方法选择PCI术后冠状动脉再狭窄病人36例,随机选择40例PCI术后无再狭窄病人对照比较研究,于PCI术前及术后3个月分别行12导联心电图测量QTd和计算较正QTd(QTcd),同时行冠状动脉造影检查,观察QTd及QTcd对PCI术前、术后有无再狭窄的影响变化。结果36例再狭窄组病人PCI术前、术后QTd及QTcd无明显差异,40例无再狭窄组病人PCI术后比术前QTd及QTcd有明显缩短(P<0.05)。再狭窄组的血管病变程度PCI术前、术后QTd及QTcd无明显变化,无再狭窄组的PCI术后比术前单支血管病变QTd及QTcd缩短(P<0.05),双支及3支血管病变QTd及QTcd明显缩短(P<0.01)。PCI术后再狭窄组的多支病变数较无再狭窄组的多支病变数的发生率明显增多。结论QTd及QTcd对评估PCI术后再狭窄有明显的临床应用价值。

Objective To assess the value of QT dispersion （QTd） on the restenosis after percutaneous coronary intervention （PCI）. Methods Data of QTd, QTcd and coronary angiography was collected and compared pre- PCI and post - PCI for thirty - six patients （pts） with restenosis and 40 pts without restenosis. Results There was no significant difference of QTd and QTcd pre - PCI and post-PCI for pts with restenosis （59.36 ms± 31.24 ms vs 57.58 ms 4±24.34 ms,62.18 ms ± 30.36 ms vs 60.87 ms ± 30.45 ms, P（ 0.05）. There was significant difference of QTd and QTcd pre - PCI and post - PCI for pts without restenosis （58.44 ms ± 30.42 ms vs 46.26 ms± 20.45 ms, 61.25 ms± 32.58 ms vs 48.63 ms ± 22.52 ms, P 〈 0.05）. The incidence of two and three branch coronary restenosis post - PCI for pts with restenosis were more than that in pts without restenosis. Conclusion QTd and QTcd were valuable for assessment of restenosis following PCI.