阿替洛尔对急性心肌梗死后患者QT离散度的影响

Influence of Atenolol on QT Dispersion in Patients after Acute Myocardial Infarction

目的 :探讨阿替洛尔对急性心肌梗死 (心梗 )后患者QT离散度 (QTd)的影响。方法 :心梗后患者 5 6例 ,随机分为试验组和对照组各 2 8例 ,对照组给予常规抗心肌缺血药物治疗 ,但不应用任何 β受体阻滞剂。试验组除给予相同的抗心肌缺血药物治疗外 ,还给予阿替洛尔 5 0～ 15 0mg/d口服 ,疗程均为 1个月。测量两组患者 12导联心电图QT间期 ,计算QTd。结果 :试验组阿替洛尔平均剂量为 74± 2 1.6mg/d ,治疗后QTd显著下降 (75 .1± 14.8msvs42 .2± 12 .9ms ,P <0 .0 1)。对照组治疗后QTd无明显改变 (72 .8± 11.6msvs77.0± 15 .7ms,P >0 .0 5 ) ,两组治疗后QTd比较差异有显著意义 (P <0 .0 1)。结论 :阿替洛尔可显著降低心梗后患者QTd ,这可能是其有效降低心梗后患者心性猝死的电生理学基础。

Objective:To study the influence of atenolol on QT dispersion (QTd) in patients after acute myocardial infarction(AMI),Methods:fifty-six patients after AMI were divided randomly into control group and trial group.The control group was treated with anti-myocardial ischemia except β blocker.The trial group was treated not only with the same anti-myocardial ischemia but also with atenolol(50mg～150mg/d),their process were a month.QT interval were measured respectively in 12-lead ECG and QTd were caluated.Results:Atenolol was used with 74±21.6mg/d in the trial group.After treatment QTd decreased significantly (from 75.1±14.8ms to 42.2±12.9ms,P<0.01)in the trial group.There was no significant difference in QTd between anterior treatment and inferior treatment in the control group (from 72.8ms±11.6ms to 77.0ms±15.7ms P>0.05).There was a significant difference in QTd after treatment between two groups(P<0.01).Conclusion:Atenolol decreases remarkablely QTd of patients after AMI,It was the base of electrophysiology that atenolol decreases significantly sudden cardiac death.\;