PTCA+支架治疗对冠心病患者QTc离散度的影响

Effect of PTCA Plus Stent on QTc Dispersion in Patients with Coronary Artery Disease

目的：探讨行ＰＴＣＡ＋支架治疗对冠心病患者ＱＴｃ离散度（ＱＴｃｄ）是否有影响。方法：对６０例成功地行单支或多支ＰＴＣＡ＋支架治疗患者术前及术后２４ｈ分别作１２导联心电图测量ＱＴｃ，并计算出ＱＴｃｄ。结果：６０例患者中，术后ＱＴｃｄ改善４４例，恶化６例，无变化１０例，术前ＱＴｃｄ为５２±１８ｍｓ，术后ＱＴｃｄ为４３±１７ｍｓ，提示ＱＴｃｄ明显降低（Ｐ＜０．０１）。结论：有效的ＰＴＣＡ＋支架治疗可显著降低冠心病的ＱＴｃｄ，ＱＴｃｄ改善可能是由于ＰＴＣＡ＋支架术后增加心肌灌注，从而降低心律失常的危险性。

Objective: To investigate the effect of PTCA + stent on QTc dispersion (QTcd) in patients with coronary artery disease. Methods: A standard 12 - lead electrocardiogram was routinely obtained before and 24 hours after successful PTCA + stent in 60 patients with coronary artery disease. QTc was measured, and QTcd was calculated. Results: Of the 60 patients, QTcd was improved in 44 patients, worsen in 6 patients, and unchanged in 10 patients. QTcd significantly decreased from 52 ± 18 ms before PTCA + stent to 43 ± 17 ms 24 hours after PTCA + stent (P < 0. 01 ). Conclusion: Successful PTCA + stent significantly reduced QTcd. Decreased QTcd may indicate improvement in myocardial perfusion caused by PTCA + stent and may be inherently beneficial by reducing the propensity for arrhythmias.