急性心肌梗死QT离散度与恶性室性心律失常关系的探讨

The Relationship between Q-T Dispersion and Malignant Ventricular Arrhythmia in Patients with Acute Myocardial Infarction

目的 探讨发生急性心肌梗死时QT离散度（Q-Td）与发生恶性室性心律失常的关系.方法 测量45例患者急性心肌梗死时的Q-Td,计算校正的QT离散度（Q-TdC）.分析Q-Td、Q-TdC与恶性室性心律失常之间的关系.根据有无室性心律失常分为观察组（n=28）与对照组（n=17）.根据Q-TdC水平（分别以60ms、80ms为分界）分析其与室性心律失常和恶性室性心律失常发生的关系.结果 观察组Q-Td、Q-TdC[（70.84±29.87）ms、（79.21±33.58）ms]与对照组[（46.19±17.03）ms、（51.64±17.71）ms]相比,差异均有统计学意义（均P＜0.05）.Q-TdC≥60ms者室性心律失常发生概率（92.30%）高于Q-TdC＜60ms者（21.05%）（P＜0.05）.Q-TdC≥80ms者恶性室性心律失常发生概率（100.00%）高于Q-TdC＜80ms者（10.34%）（P＜0.05）.结论 急性心肌梗死随着Q-Td或Q-TdC值的增大,发生恶性室性心律失常的概率增高.

Objective evaluate the relationship between QT dispersion （Q-Td） and malignant ventricular arrhythmia （VA） in patients with acute myocardial infarction （AMI）. Methods 28 AMI patients with VA （VA group） and 17 AMI patients without VA （control group） were included. Q-Td and corrected Q-Td（Q-Tdc） were measured and calculated. The relation of Q-Tdc to VA and malignant VA was analyzed on two levels of Q-Tdc （Q-Tdc=60ms, 80ms）. Results Q-Td and Q-Tdc were significantly different between VA group （70.84±29.87,79.21±33.58） and control group （46.19 ±17.03,51.64±17.71） （P 〈0.05）. VA occurred more often in patients with Q-Tdc≥60ms than in patients with Q-Tdc〈60ms （92.30% vs. 21.05%,P〈0.05）. Malignant VA occurred more frequently in patients with Q-Tdc≥80ms than in patients with Q-Tdc 〈 80ms （100% vs 10.34%,P〈 0.05）. Conclusion The incidence of malignant VA increases with increased Q-Td or Q-Tdc in patients with AMI.