急诊PCI和静脉溶栓对3小时内急性心梗QT离散度的影响

Influence of Emergency PCI and Intravenous Thrombolytic Therapy on QT Dispersion of Acute Myocardial Infarction within Three Hours

目的探讨发病3 h内的急性ST段抬高性心肌梗死(STEMl)行急诊冠状动脉介入治疗(PCI)与静脉溶栓(尿激酶)疗法对QT离散度(QTd)的影响。方法入选68例发病3 h以内STEMI的患者随机分为2组,即急诊PCI组与静脉溶栓组。观察急诊PCI组、静脉溶栓组在治疗前及治疗后24 h的QTd变化,同时对两者进行对比分析。结果急诊PCI组QTd从术前的(78.2±10.8)ms降至术后的(39.7±6.16)ms(P<0.01),静脉溶栓组QTd从由溶栓前的(77.9±10.3)ms降至溶栓后的(43.6±7.1)ms(P<0.01)。两者治疗后进行对比QTd差异有统计学意义(P<0.05)。结论对于发病3 h内STE-MI患者急诊PCI降低QTd优于静脉溶栓疗法。急诊PCI术后QTd缩短更显著,表明急诊PCI疗效更佳。

[Objective]To study the influence of emergency percutaneous coronary intervention（PCI） and intravenous thrombolytic therapy（urokinase） on QT dispersion（QTd） of ST-elevation myocardial infarction（STEMI） within three hours. [Methods]60 patients with STEMI within three hours were randomly divided into the emergency PCI group and the intravenous thrombolysis group.The QTd changes before and 24 hours after treatment of two groups were observed and compared. [Results]After treatment,QTd declined from（78.2±10.8） ms to（39.7±6.16） ms in the emergency PCI group（P0.01）,and QTd declined from（77.9±10.3） ms to（43.6±7.1） ms in the intravenous thrombolysis group（P0.01）.There was significant difference in QTd after treatment between two groups（P0.05）. [Conclusion]The emergency PCI had better effect than intravenous thrombolytic therapy on QTd decline in patients with STEMI within three hours.QTd shortened obviously after emergency PCI,which indicates that emergency PCI has better efficacy.