心肌缺血和冠状动脉病变对QTc离散度的影响

QTc Dispersion in Myocardial Ischemia and Multi Vessel Coronary Artery Disease

为探讨ＱＴｃ离散度（ＱＴｃｄ）与心肌缺血和冠状动脉（简称冠脉）病变程度的关系，分析２８例冠脉正常和５７例冠心病患者１２导联心电图的ＱＴｃｄ。结果示：冠心病组ＱＴｃｄ较冠脉正常组显著增大（４６．７±１２．６ｍｓｖｓ２６．３±１０．９ｍｓ，Ｐ＜０．０１）；不稳定型心绞痛ＱＴｃｄ明显大于稳定型心绞痛者（５４．６±１３．７ｍｓｖｓ４２．３±１４．１ｍｓ，Ｐ＜０．０５）；双支病变与单支病变以及三支病变与双支病变相比，ＱＴｃｄ均有显著增大（４８．７±１３．２ｍｓｖｓ３５．７±１１．９ｍｓ及５９．６±１５．１ｍｓｖｓ４８．７±１３．２ｍｓ，Ｐ均＜０．０５）。提示心肌缺血是引起冠心病患者ＱＴｃｄ增大的主要原因之一，ＱＴｃｄ的变化对于判断心肌缺血和冠脉病变程度有一定价值。

To assess the relation of QTc dispersion (QTcd) in myocardial ischemia and severity of coronary artery stenosis,QTcd on 12 lead ECG was measured in 57 patients with coronary heart disease and 28 controls.The results showed:①QTcd in patients with coronary artery disease was significantly increased than that of controls (46.7 ±12.6 ms vs 26.3±10.9 ms, P <0.01);②QTcd was longer in patients with unstable angina than that in patients with stable angina(54.6±13.7 ms vs 42.3±14.1 ms, P <0.05);③Compared with single vessel disease group,QTcd was prolonged significantly in two vessel disease group(48.7±13.2 ms vs 35.7±11.9 ms, P < 0.05 ),and QTcd in three vessel disease group was increased significantly than that in two vessel disease group (59.6 ±15.1 ms vs 48.7±13.2 ms, P <0.05).The results suggest that QTcd have a predictive value for the presence of myocardial ischemia and severity of coronary artery stenosis.