急性心肌梗死早期患者QT离散度的变化及其意义

Clinical significance of QT dispersion of patients in early stage of acute myocardial infarction

目的探讨急性心肌梗死(acute myocardial infarction,AMI)早期患者QT间期离散度(QT dispersion,QTd)的变化及其意义。方法回顾性分析51例AMI患者(AMI组)(包括39例无心室颤动患者及12例心室颤动患者)和48名健康体检者(对照组)的心电图资料,比较AMI组与对照组的QTd和QTcd、39例无心室颤动患者及12例心室颤动患者的QTd和QTcd。结果AMI组入院后即刻行标准12导联心电图检查,对照组选择15min后行静息心电图检查,测量并计算QTd。AMI组QTd、QTcd明显高于正常对照组,差异有统计学意义[(69.9±20.3)ms比(32.5±12.6)ms,P<0.01;(85.3±32.8)ms比(40.9±15.7)ms,P<0.01];AMI组中心室颤动组QTd、QTcd明显大于无心室颤动组,差异有统计学意义[(112.3±22)ms比(59.6±21.5)ms,P<0.01;(120.1±12)ms比(68.1±22.4)ms,P<0.01]。结论AMI早期QTd增高,QTd的延长对预测AMI患者的严重室性心律失常有重要的临床价值。

Objectives To study the clinical significance of QT dispersion （OTd） of patients in early stage of acute myocardial infarction （AMI）. Methods We retrospectively analyzed the electrocardiogram data of 51 AMI patients （AMI group, including 12 patients with ventricular fibrillation and 39 patients without ventricular fibrillation） and 48 healthy volunteers （control group ）. Compared the QTd and QTcd of the AMI group and control group, patients with and without ventricular fibrillation. Results The QTd and QTcd in AM/group were obviously higher than that in control group and the difference had statistical significance [ （69.9±20.3） ms vs. （32.5±12.6） ms, P〈0.01; （85.3±32.8） ms vs. （40.9±15.7） ms, P〈0.01 ]. And among the patients in early stage of acute myocardial infarction, the QTd and QTcd of patients with ventricular fibrilation was obviously higher than that of patients without ventricular fibrilation, the difference had statistical significance [ （112.3±22） ms vs. （59.6±21.5） ms, P〈0.01 ; （120.1± 12） ms vs. （68.1±22.4） ms, P〈0.01 ]. Conclusions The QTd of patients in early stage of AMI increases obviously than that in normal person. Increase of QTd is of great clinical importance in predicting serious cardiac arrhythmia in patients with AMI.