ST段抬高心肌梗死溶栓治疗对Q-T离散度临床影响和意义

Clinical impact of ST-segment elevation myocardial infarction thrombolytic therapy on QT dispersion and its significance

目的探讨ST段抬高心肌梗死(STEMI)患者溶栓治疗对Q-T离散度(G-Td)的临床影响和意义。方法 STEMI患者发病在12小时内溶栓治疗的111例患者,按溶栓治疗后,冠状动脉是否再通,分为再通组(73例)和无再通组(38例)。测定并记录溶栓前、溶栓后2小时和24小时的G-Td。结果溶栓前两组STEMI患者的G-Td无明显性差异(P>0.05),溶栓后再通组的G-Td明显低于无再通组,有明显性差异(P<0.05);溶栓前两组的室性心律失常无明显性差异(P>0.05),溶栓后再通组的室性心律失常明显低于无再通组(P<0.05)。结论 STEMI患者有效的溶栓治疗,可以缩短G-Td、改善心肌细胞电稳定性、减少室性心律失常的发生。

Objective To investigate the therapy clinical impact of thrombolytictherapy in theST - segment elevationmyocardialinfarction （STEMI） patients on QT dispersion （ G - Td） andits significance. Methods 111 STEMIpatientsonset who got thrombolytic therapywithin 12 hours were divided into recanalizationgroup（73 cases） andnorecanalizationgroup （38 cases） according to the coronary recanalization afterthrombolytic therapy, measured and recorded G -TD before thrombolysis, 2 hoursand 24hoursafterthrombolytic. Results G -TD had no obvious differences in two groups before thrombolysis（ P 〉 0.05 ）. After thrombolysis ,recanalizationgroup^G - Td was significantly lower than that of thenorecanalizationgroup, there were significantdifferences （ P 〈 0. 05 ） ; Beforethrombolysis, ventricular arrhythmiasinboth groups had nosignificantdifferences （ P 〉 0. 05 ）, ventricular arrhythmias in recanalizationgroupwas significantly lower than that in norecanalizationgroup after thrombolysis （P 〈 0. 05 ）. Conclusions Effectivethrombolytic therapyin patients with STEMIcan shorten theG - Td, improvecardiac electrophysiologystability and reducetheincidenceofventricular arrhythmias.