急性心肌梗死急诊介入治疗后早期T波倒置与Q-T离散度的关系

ASSOCIATION BETWEEN QT DISPERSION AND T WAVE INVERSION IN ACUTE MYOCARDIAL IN-FARCTION AFTER INTERVENTIONAL THERAPY

目的观察急性心肌梗死急诊介入治疗后早期T波倒置与Q-T离散度的关系。方法观察65例急性心肌梗死行急诊介入治疗患者,根据其是否在介入治疗后24h内出现T波倒置,将患者分为T波倒置组45例,未倒置组20例,分别观察肌酸激酶同工酶(CK-MB)、室性心律失常发生率、Q-T离散度及预后。结果 T波倒置组肌酸激酶同工酶峰值减低、达酶峰时间提前、QTd及QTcd显著缩短,随访6个月,T波倒置组较未倒置组患者心功能改善明显,心血管事件发生率低。结论 Q-T间期离散度变化和介入治疗后是否早期T波倒置均为心肌组织水平再灌注的简易临床指标,与临床预后有密切关系。

Objective To explore the association between QT dispersion and T wave inversion in acute myocardial infarction. Methods A retrospective study was performed in 65 cases of acute myocardial infarction patients after emergency interventional therapy. According to whether appear T wave inversion after the thrombolysis in 24 hours, the patients were divided into T wave inversion group 34 cases, T wave normal group 31 cases. The kinase isoenzyme MB （CK- MB）, the incidence of ventricular arrhythmia, QTd and prognostic were adopted as observation indexes. Results In group-of T wave inversion, the CK- MB peak reduce, reach enzyme peak ahead of time, QTd and corrected QT dispersion（QTcd） were significantly shorten. A 6 months of follow- up after emergency interventional therapy, the cardiac function improved significantly and showed lower the risk of cardiovascular in T wave inversion group than T wave normal group. Conclusion The variation of QTd and early T wave inversion is clinical index in myocardial reperfusion after thrombolysis, they are closely related to clinical prognosis.