不同临床类型冠心病的QTc离散度

Research of QTc Dispersion in the Patients With Different Types of Coronary Heart Disease

分析１０９例经冠状动脉（简称冠脉）造影证实的不同类型冠心病患者ＱＴｃ离散度（ＱＴｃｄ），以４１例临床疑有冠心病而冠脉造影正常者作对照。结果显示：冠心病各组ＱＴｃｄ均明显大于对照组（６２．２９±２２．１９ｍｓ、７３．４４±２３．７７ｍｓ、１００．００±２０．１９ｍｓｖｓ３５．１９±１４．１８ｍｓ），Ｐ均＜０．００１。陈旧性心肌梗塞组的ＱＴｃｄ明显大于心绞痛组（７３．４４±２３．７７ｍｓｖｓ６２．２９±２２．１９ｍｓ），Ｐ＜０．０５；陈旧性心肌梗塞合并室壁瘤组ＱＴｃｄ显著大于陈旧性心肌梗塞组（１００．００±２０．１９ｍｓｖｓ７３．４４±２３．７７ｍｓ），Ｐ＜０．００１。前壁与下壁心肌梗塞患者ＱＴｃｄ比较无显著性差异（７３．５０±２４．３４ｍｓｖｓ７３．３３±２３．８７ｍｓ，Ｐ＞０．０５）。冠脉单支、双支及三支病变者ＱＴｃｄ（分别为７６．１８±２４．２５ｍｓ、７８．００±２８．５８ｍｓ和８０．２１±２５．１４ｍｓ）比较无显著性差异，Ｐ＞０．０５。提示不同临床类型冠心病患者心肌复极存在明显差异，陈旧性心肌梗塞伴室壁瘤形成者ＱＴｃｄ增大最显著，ＱＴｃｄ与梗塞部位及冠脉病变支数无关。

QTc dispersion (QTcd) was studied in 109 patients with different types of coronary heart disease confirmed by coronary angiography and 41 patients suspectable of coronary heart disease with normal coronary angiography.The results show that QTcd in patients with different types of coronary heart disease were larger than that in control group ( P <0.001 respectively).There was a larger QTcd in old myocardial infarction group compared with angina pectoris group (73.44±23.77 ms vs 62.29±22.19 ms, P <0.05).There was the greatest QTcd in patients with myocardial infarction with ventricular aneurysm(100.00±20.19 ms).However,no significant difference of QTcd was found between anterior myocardial infarction and inferior infarction(73.50±24.34 ms vs 73.33± 23.87 ms, P >0.05).In addition,there was not significant difference in QTcd among the groups of single,double and triple vessels diseases( P >0.05).In conclusion,there is significant regional variation in ventricular electrical recovery in coronary heart disease.QTcd increases most significantly in the patients with ventricular aneurysm.QTcd dispersion is not related to postition of myocardial infarction and number of coronary lesion vessel.