缺血预适应对急性心肌梗死Q-T离散度及室性心律失常的影响

Effect of ischemic preconditioning on Q-T dispersion and ventricular arrhythmia in acute myocardial infarction

目的探讨缺血预适应对急性心肌梗死Q_T间期离散度及室性心律失常的影响。方法根据318例首次急性心肌梗死患者发病前48h内是否发生心绞痛 ,分为缺血预适应组 (186例 )和无缺血预适应组 (132例 ) ,另取健康人111例作为对照组 ,测定每例校正Q_T间期离散度 (Q_Tcd)。结果无缺血预适应组Q_Tcd(70.47±12.05ms)明显大于缺血预适应组 (55.96±10.41ms ,P<0.01) ,缺血预适应组明显大于对照组 (42.47±9.17ms,P<0.01)。缺血预适应组室性心动过速、心室颤动及猝死的发生率明显低于无缺血预适应组 (P均<0.01)。结论缺血预适应可明显减小急性心肌梗死时的Q_T离散度 。

Objective To investigate effect of ischemic preconditioning on Q _ T dispersion(Q _ T d)and ventricular arrhythmia in acute myocardial infarction. Methods Three hundred and eighteen cases of first AMI were divided into 2 groups according to angina pectoris within 48 hours before AMI:ischemic preconditioning(IP)group(n=186);no ischemic preconditioning(NIP) group(n=132),Q _ T d was measured in 318 patients and in 111 normal individuals.Results Q _ T cd of NIP group (70.47±12.05ms) was significantly increased than those of IP group( 55.96±10.41 ms,P<0.01).Q _ T cd of IP group was significantly increased than those of control group(42.47±9.17 ms,P<0.01).Incidenced of ventricular tachycardia,ventricular fibrillation and sudden death was lower in IP group than those in the NIP group(P<0.01).Conclusion Myocardial ischemic preconditioning might lead to decrease of Q _ Td in AMI and incidences of ventricular tachycardia and sudden death.