急性心肌梗死QT间期及JT离散度变化的临床意义

Clinical Significance of QT and JT Interval Dispersity in Acute Myocardial Infarction

目的：探讨急性心肌梗死（AMI）早期QT间期离散度（QTd）与JT间期离散度（JTd）的变化及其临床意义。方法：测定61例AMI患者及70例正常对照组的QTd、JTd及校正后的QT与JT间期离散度（QTcd、JTcd）。结果：（1）AMI组QTd、JTd较对照组显著增大（均P＜0．001）。（2）不同梗死部位的QTd、JTd无明显差异（P＞0．05）。（3）合并严重室性心律失常者明显大于无室性心律失常者（P＜0．001），（4）心源性死亡组显著大于未死亡者。（5）EF≤45％组大于EF＞45％组（P＜0．01）。结论：AMI早期QTd、JTd显著增大，与严重室性心律失常的发生、心源性死亡及心功能状况密切相关，提示QTd的测定对预测心脏事件和猝死有重要参考价值。

Objective: To discuss the changes and clinical sighficanee of QT interval dispersity (QTd)、 JT interval dispersty (JTd) in early stage of acute myocardial infarction (AMI). Methods: QTd、JTd and corrected QT dispersity (QTcd)、corrected JT dispersity (JTcd) were measured in 61 patients with AMI, compared with 70 normal controls. Results: ①QTd and JTd of patients with AMI were significantly greater than those of normal group. ②QTd and JTd Showed no obvious changes in patients with different infarction .③QTd、JTd in patients with serious ventricular arrhythmia were greater than those without Ventricular arrhythmia .④Significant increases of QTd and JTd were found in patients with cardiac sudden death. ⑤QTd、JTd of AMI patients were significantly greater in EF≤45% group than those of EF > 45% group. Conclusions: The QTd and JTd increase significantly in patients at early stage of AMI. The increases are closely related with the occurence of serious ventricular arrhythmia, cardiac sudden death and hial failure, suggesting that these changes are important inprediction of cardiac events and sudden death.