50例急性心肌梗死患者Q-Tc离散度与心肌酶变化的相关分析

Analysis of comparision of Q T c dispersion with the changes of serum markers of myocardial damage in 50 patients with acute myocardial infarction

目的 :探讨急性心肌梗死患者Q Tc 离散度 (Q Tcd)与心肌酶的变化。方法 :对 5 0例急性心肌梗死患者第1d和第 7d体表心电图的Q Tcmax和Q Tcd及第 1d和第 7d的心肌酶AST、CK MB、LDH、α HBD及LD/α HBD的检测值进行统计并作对比分析 ,另作Q Tcd和心肌酶相关性检验。结果 :急性心肌梗死第 1d和第 7d比较Q Tcmax差异不显著 (P >0 0 5 ) ,但Q Tcd第 7d比第 1d增大差异非常显著 (P <0 0 0 1) ,第 7d的Q Tcmax与Q Tcd呈明显正相关 (r=0 3 75 ,P <0 0 0 1)。急性心肌梗死第 7dQ Tcmax较正常成人明显延长 (P <0 0 0 1)。急性心肌梗死患者AST、CK MB第 7d较第 1d平均值均明显下降 (P <0 0 0 1) ,但LDH和LD/α HBD前后差异不明显 (P均 >0 0 5 ) ,表明变化缓慢。Q Tcd与CK MB之间相关性不明显 (P >0 0 5 ) ,Q Tcd与LDH或LD/α HBD之间也没有明显相关性 (P >0 0 5 )。结论 :急性心肌梗死时Q Tcd和心肌酶各为独立的参数 。

Aim: To search for both Q T c dispersion (Q T cd ) and the changes of serum markers of myocardial damage in acute myocardial infarction (AMI). Methods: Q T cmax and Q T cd of body surface electrocardiography and values of serum markers of myocardial damage, such as AST, CK MB, LDH, α HBD and LD/α HBD in 50 patients with AMI have been statistically analysed on the lst and 7th day respectively. At the same time, correlation test between Q T cd and serum markers of myocardial damage has been performed. Results: In AMI, comparing Q T cmax on the 1st day with that on the 7th day, the difference is not significant ( P >0 05), but Q T cd on the 7th day was significantly larger than that on the 1st day ( P <0 001). There was a positive relationship ( r =0 375 P <0 001) on the 7th day between Q T cmax and Q T cd . Q T cmax on the 7th day in AMI was significantly longer than in normal adult ( P <0 001). In patients with AMI, the mean values of AST and CK MB on the 7th day were significantly lower than these on the 1st day ( P <0 001). But they were not significant between LDH and LD/α HBD (all P >0 05). The above enzyme changes are going very slowly. There was no relationship, not only between Q T cd and CK MB ( P >0 05) but also between Q T cd and LDH of LD/α HBD ( P >0 05). Conclusion: In AMI, Q T cd and serum markers of myocardial damage both are independent parameter. There is no correlation between Q T cd and serum markers of myocardial damage in AMI.