直接经皮腔内冠状动脉成形术对急性心肌梗死QT离散度的影响

Effect of Direct Percutaneous Transluminal Coronary Angioplasty on QT Dispersion in Acute Myocardial Infarction

目的 :观察直接经皮腔内冠状动脉成形术 (PTCA)对急性心肌梗死 (AMI)患者QT间期离散度 (QTd)的影响。方法 :采用标准 12导联心电图 ,对直接PTCA组 2 6例和未再灌注治疗组 30例AMI患者行心电图描记 ,分别测量入院时、直接PTCA后2h、2 4h、1周、2周的QTd值 ,并观察两组恶性室性心律失常事件的发生。结果 :直接PTCA组与未再灌注治疗组入院时QTd无差异 (P >0 .0 5 ) ,直接PTCA组除术后 2hQTd一过性增大外 ,2 4h后明显缩小 ,与未再灌注治疗组比较差异显著 (P <0 .0 1) ,同期直接PTCA组恶性室性心律失常发生率低 (P <0 .0 1)。结论 :AMI后直接PTCA能缩小患者QTd ,并能降低急性期恶性室性心律失常事件的发生。

Objective: To assess the influence of direct PTCA on QT dispersion. Methods: QT dispersion were calculated in 26 patients with AMI by direct PTCA and 30 patients without reperfusion. QT dispersion were calculated before and after direct PTCA 2h?24h?1w and 2w by analyzing the 12 leads ECG. We also followed up the incidence of fatal ventricular arrhythmia at the same time. Results: At 2h after PTCA, QT dispersion increased transiently. But at 24h after PTCA, QT dispersion decreased significantly as compared with the non-reperfusion patients ( P< 0.01). At the same time the incidence of fatal ventricular arrhythmia in primary PTCA patients was lower than that in the non-reperfusion patients ( P< 0.01 ). Conclusion: Primary PTCA may reduce QT dispersion and the incidence of malignant ventricular arrhythmia in AMI patients.