QT离散度与冠状动脉狭窄病变的关系及冠状动脉支架置入术对它的影响

The relationship between QT dispersion and coronary artery stenosis and the effects of stent implantation on QT dispersion in the patients with severe coronary artery stenosis

目的探讨QT离散度(QTd)与冠状动脉狭窄病变程度和范围的关系及支架置入术前后QTd的变化。方法分析119例经选择性冠状动脉造影患者的心电图资料,观察不同狭窄程度和范围的冠状动脉病变QTd指标以及冠脉重度狭窄者支架置入术前后QTd的变化。结果冠脉正常组QTd为46.7±10.3m s,轻度狭窄组(49.4±10.6m s)与正常组之间无明显差异(P>0.05)。重度狭窄组(68.5±10.7m s)与中度狭窄组(60.8±10.5m s)相比,中度狭窄组与轻度狭窄组相比,QTd均显著增大(P<0.01)。单支病变组QTd为55.3±10.4m s,与正常组比较差异显著(P<0.01);多支病变组(69.3±10.1m s)与双支病变组(62.5±10.2m s)比较,双支病变组与单支病变组比较,QTd均显著增大(P<0.05)。重度狭窄组支架置入术后QTd为44.9±10.1m s,与术前比较明显减小,差异有显著性(P<0.01)。结论QTd增大提示冠脉狭窄更严重,病变范围更广泛。成功的支架植入术可明显缩短冠脉重度狭窄患者QTd。

Objective To find out the relationship between QT dispersion （QTd） and the abnormality of the extent and range of coronary artery stenosis, To find out the effects of the treatmeats,by stent implantation on QTd in the patients of coronary heart disease. Methods The abnormality of the extent and range of coronary artery stenosis and QTd were recorded among 119 patients receiving coronary angiography. 27 patients with severe coronary artery stenosis underwent stent implantation, the change of QTd were recorded after stent implantation with ECG. Results ①The QTd of the patients with light stenosis group （49.4 ± 10.6ms） compared with normal coronary artery （46.7 ± 10.3ms） were no significant difference （ P 〉0.05）. However, the QTd of the patients of the severe stenosis group （68.5 ± 10.7ms） were increased （ P 〈0.01 ） compared with the medium stenosis group （60.8 ± 10.5ms）, as well as the medium stenosis group compared with light stenosis group （ P 〈0.01 ）. ②The QTd of the patients with lesion of singe - vessel disease （ 55.3 ± 10.4ms） were significantly increased compared with the patients with normal coronary artery （p 〈 0.01 ）. The QTd of muliti -vessel disease group（69.3± 10. 1 ms） were longer than doublevessel disease group（ 62.5± 10.2ms）, double - vessel disease group were longer than singe - vessel group, respectively （ p 〈 0.05 ）. ③In severe stenosis group, the QTd were significantly reduced after stent implantation （44.9 ± 10. 1 ms） compared with that with before operation （ P 〈 0.01 ）. Conclusion QTd helps to reflect the extent and range of coronary artery stenosis. Successful stent implantation can reduced QTd of the patients with severe coronary artery stenosis.