急性心肌梗死溶栓治疗对Q-T离散度的影响及意义

Influence of thrombolytic therapy on Q-T dispersion of acute myocardial infarction and its significance

目的:探讨急性心肌梗死(AMI)患者静脉溶栓治疗对Q-T离散度的影响及意义。方法:AMI发病6 h内静脉溶栓治疗的69例患者,按溶栓后冠脉有无再通分为再通组(45例)和未再通组(24例),测定溶栓前、溶栓后2 h和24 h的Q-T离散度。结果:溶栓前两组AMI患者的Q-T离散度无显著性差异(P>0.05),溶栓后Q-T离散度再通组明显低于未通组,有显著性差异(P<0.05)。Lown氏3级以上室性心律失常,溶栓前两组无显著性差异(P>0.05),溶栓后再通组显著低于未再通组(P<0.05)。结论:AMI患者早期有效的溶栓治疗可缩短Q-T离散度、改善心肌电稳定性、减少恶性心律失常的发生;Q-T离散度具有预测恶性心律失常发生的价值。

Objective ： To study the influence of thrombolytic therapy on Q-T dispersion of acute myocardial infarction （AMI） and its significance. Methods： Sixty-nine patients with AMI undergoing thrombolytic therapy in 6 hours were divided into trial group （n = 45） and control group （n = 24 ） according to the effects of therapy; the occluded arteries of patients in trial group were recanalized ; the occluded arteries of patients in control group were not recanalized. Q-T dispersions were measured before and after thrombolysis in 2 hours and 24 hours. Results： There was no significant difference of the Q-T dispersions in the two groups before thrombolysis; there was significant difference of the Q-T dispersions in the two groups after the thrombolysis （P 〈0. 05）, the Q-T dispersions in trial group was markedly lower than that in control group. Of the incidence of grade 3 and above ventricular arrthythmia of Lown＇s, there was no significant difference in the two groups before thrombolysis （P 〉 0. 05） ; there was significant difference in the two groups after thrombolysis （P 〈 0. 05 ）, which in trial group was markedly lower than that in control group. Conclusion： Effective early thrombolytic therapy for AMI may shorten the Q-T dispersions, improve the stability of cardiac-electricity, reduce severe arrhythmia. Q-T dispersion has value of predicting severe ventricular arrhythmia.