急性心肌梗死早期QT离散度与严重室性心律失常的关系

The relationship between QT dispersion and severe ventricular arrhythmia at the early stage of acute myocardial infarction

目的 探讨急性心肌梗死 (AMI)早期QT离散度(QTd)、校正后的QT离散度 (QTcd)的变化及其与严重室性心律失常 (SVA )的关系。方法 选择 12 5例AMI患者(AMI组 )和 6 0例健康人 (对照组 ) ,测定其QTd和QTcd ,并根据AMI伴有或不伴有SVA的发生将AMI组再分为SVA组和无SVA组 ,各组进行对比分析。结果 AMI早期QTd与QTcd均大于对照组 (P <0 0 1) ;SVA组的QTd、QTcd也较无SVA组增大 (P <0 0 1) ;若以QTd≥ 6 0ms为AMI早期发生SVA的预测值 ,则敏感性为 6 8 2 % ,特异性为6 4 2 %。假阳性率为 35 8% ,假阴性率为 31 8%。结论 AMI早期严重室性心律失常与QTd、QTcd增大有密切关系 。

Objective To study the relationship between QT dispersion (QTd), corrected QT dispersion (QTcd)and severe ventricular arrhythmia (SVA) at the early stage of acute myocardial infarcton (AMI). Methods QTd and QTcd in 125 patients with AMI(44 patients with SVA, 81 patients without SVA) and 60 normal controls were measured and compared. Results QTd and QTcd were significantly prolonged ( P< 0 01) in patients with AMI, compared with normal controls. QTd and QTcd were greater in patients with SVA than in patients without SVA (P<0 01). As QTd and QTcd increased, the rate of SVA at the early stage of AMI was significantly increased. Conclusion QTd has relatively great practical value for predicting SVA at the early stage of AMI.