QT离散度对急性心肌梗塞合并快速室性心律失常的预测

Prediction of QT interval dispersion on AMI with venticular tachyarrhythmias

对１５例正常者，１９例急性心梗（ＡＭＩ）４周内无室速，及２０例ＡＭＩ４周内合并室速室颤的ＡＭＩ后２４ｈ左右心电图，进行ＱＴ离散度分析。结果：正常组ＱＴｄ为（１９２±６２）ｍｓ、ＱＴｃｄ为（２３６７±１５９８）ｍｓ，ＡＭＩ无室速者ＱＴｄ（５８４２±２２６）ｍｓ、ＱＴｃｄ（５８５６±２５８７）ｍｓ，ＡＭＩ合并室速室颤者ＱＴｄ（１００５±２６１）ｍｓ、ＱＴｃｄ（１０４２±３２９１）ｍｓ，三组间有显著差异。并以本组资料正常者的ＱＴｃｄｘ＋３ｓ为正常上限，预测ＡＭＩ是否合并室性心律失常的敏感性８０％、特异性７８９％、准确性８０％。

The QT dispersion in 15 normal subjects ,19 AMI patients without and 20 AMI patients with venticular tachyarrhythmias (VT) within 4 weeks of AMI was observed.The results showed that QT d(QT disperssion)and QT cd (QT corrected disperssion)in normal subjects were (19 2±6 2)ms and (23 67±15 98)ms,in patients without VT:(58 42±22 6)ms and (58 56±25 87)ms and in patients with VT:(100 5±26 1)ms and (104 2±32 91)ms; there were significant differences between the 3 groups.When the QT cd (x±3s) of the normal subjects were used as the normal upper limit to predict whether AMI patients were complicated with VT, the QT cd had a sensitibility of 80%.a specificity of 78 9% and a positive predictive accuracy of 80%.It is a simple noninvasive measure for identifying patients with or without VT.