溶栓治疗对急性心肌梗死患者QT离散度的影响

The Influence of Thrombolytic Therapy on QT Dispersion with Acute Myocardial Infarction

目的:探讨急性心肌梗死(AMI)患者静脉溶栓前后QT离散度(QTd)变化及其对预后的影响。方法:105例AMI患者分为溶栓再通组、未通组和未溶栓组。测定其溶栓前及溶栓治疗1、2周后QTd变化,并与未溶栓组比较。同时比较三组治疗2周时高危室性心律失常。结果:溶栓治疗再通治疗1、2周后QTd显著缩小(P皆<0.01),高危室性心律失常的发生率低.其与未通组和未溶栓组比较,差异皆有显著性(P<0.01)。而未通组、未溶栓组治疗前后QTd变化和高危室性心律失常的发生率皆无差异(P<0.05)。结论:AMI后2周内QTd增大者,其溶栓再通的可能性小,发生高危室性心律失常的可能性增大。

Purpose:To study the changes of QT dispersion (QTd) before and after thrombolytic therapy and its influ-ence on prognosis of patients with acute myocardial infarction (AMI) .Methods: 105 patients with AMI were divided into three groups: Thrombolytic reperfusion group, non - reperfusion group and non - thrombolytic therapy group. The disper-sion value of QT for the three groups were successive monitored by dynamic electrocardiographic lead before and after treatment.Results:The QTd value of reperfusion group was clearly reduced at one and two weeks after thrombolytic thera-py ( P all < 0.01), and the incidence of high risk ventricular arrhythmia in the reperfusion group was obviously lower than that in the thrombolytic non - reperfusion group as well as the non - thrombolytic therapy group( P all < 0.01) .There were not a pictorial difference in QTd and incidence of high risk ventricular arrhythmia value between the non - reperfu-sion and non - herombolytic therapy groups( P all > 0.05). Conclusion:The more QTd values increase in the patients af-ter AMI, the more presumable reperfusion after thrombolytic therapy, and the higher morbidity of the high risk ventricular arrhythmia were within two weeks.