老年急性心肌梗塞患者溶栓治疗后QTc间期的变化

Changes in QTc interval after thrombolytic therapy in the aged patients with acute myocardial infarction

为探讨老年急性心梗患者溶栓治疗后ＱＴｃ间期的变化，将老年ＡＭＩ患者分为溶栓组（２３例）和未溶栓组（２５例），两组患者发病后ＱＴｃ间期平均值均延长，两组比较无统计学差异。溶栓组溶栓后１日ＱＴｃ间期明显延长，第２ｄ达高峰后迅速缩短，而未溶栓组发病后１～３日ＱＴｃ间期无明显变化，从发病第４ｄ起缓慢缩短。溶栓所致的ＱＴｃ间期延长可能于缺血后再灌注损伤有关。比较两组不同时间的ＱＴｃ间期除溶栓后第２ｄ有统计学差异外，其余均无统计学差异；而比较两组不同时间的ＱＴｃ间期变化均有统计学差异。因此在评价老年ＡＭＩ患者溶栓疗效时，比较ＱＴｃ间期缩短的速度比单纯比较溶栓后某时间ＱＴｃ间期意义更大。

Fourty-eight aged patients with acute myocardial infarction were divided into two groups Of them,23 were treated with thrombolysis(group 1),and 25 were not (group 2).QTc interval prolongation happened in both groups,and no statistic difference between them before treatment In group 1,QTc interval prolonged evidently in the 1st day after thrombolysis and reached peak in the 2nd day,afterwards it dropped rapidly In group 2, QTc interval unchanged evidently in the first three days and it dropped slowly from the 4th diseased day This may be related with reperfusion of ischemia QTc interval between two groups was not different statistically except the 2nd day after thrombolysis,but the changes of QTc interval between two groups were significantly different statistically The results suggest that comparing the shortening speed of QTc interval could be more effective than QTc interval comparison for evaluating the curative effects of thrombolytic therapy on the aged AMI