老年急性心肌梗塞QT离散度变化及临床意义

Changes of QT dispersion on electrocardiogram in aged patients with early acute myocardial infarction and clinical significance

目的探讨老年急性心肌梗塞（ＡＭＩ）早期心电图ＱＴ离散度（ＱＴｄ）变化特点，ＱＴｄ与临床表现的关系，以及ＱＴｄ对预后的意义。方法测量老年ＡＭＩ组和非老年ＡＭＩ组各５０例及老年无心脏病组５４例１２导联心电图ＱＴｄ（ＪＴｄ），即ＱＴ间期（ＪＴ）最大值与最小值之差，计算出ＱＴｃｄ（ＪＴｃｄ）。结果老年ＡＭＩ组ＱＴｄ（ＪＴｄ）与其他２组分别有非常显著性差异（Ｐ＜０．００５～０．００１）。两ＡＭＩ组死亡与生存者ＱＴｄ（ＪＴｄ）均有显著、非常显著性差异（Ｐ＜０．０５～０．０１）。老年ＡＭＩ组重度泵衰竭、室性心律失常发生率及死亡率高于非老年ＡＭＩ组。结论ＱＴｄ（ＪＴｄ）可作为判断ＡＭＩ患者病情与预后的一项有价值的指标，对老年ＡＭＩ患者更具有临床意义。

Objective To explore charcteristic change of QTd on ECG in the aged patients with early AMI,a relationship between QTd and clinical presentation as wellas significance of QTd for prognosis. Methods QTd(JTd)on 12lead ECG was measured in 50 aged and 50 nonaged patients with AMI,and 54 aged healthy person.QTd=QTmaxQTmin,QTcd(JTcd)was calculated so as to correct the effects of heart rate. Results The results showed that the differences of QTd in the three groups were significant (P<0005～0001)。QTd(JTd)in the fatal patients was obviously higher than that in the survivers in both AMI groups (P<005～001).The morbidity of serious pump failure and ventricular arrhythmias,death rate in aged AMI group are higher than nonaged AMI group. Conclusions QTd may be valuable signals to assess the degree and prognosis of patients with AMI.The important significance of QTd for aged AMI patients is demonstrated.