冠心病心绞痛患者QT间期离散度变化及药物干预的影响

Variation of QT Dispersion in Patients with Angina Pectoris and Effects of Relative Drugs on QT Dispersion

目的:探讨冠心病心绞痛患者心肌缺血程度与QT间期离散度(QTd)和校正后QT间期离散度(QTcd)的变化,及药物干预对其影响。方法:68例心绞痛患者,分为稳定性(35例)及不稳定性(33例)两组,与30例正常人对照。记录同步12导联心电图,测量各导联QT间期,用QTmax-QTmin得QTd,并用BazetS公式算出QTcd。同时观察冠心病人经鲁南欣康注射液治疗前后心电图心肌缺血及QTd和QTcd的改变。结果:两组心绞痛患者QTd及QTcd长于对照组(P<0.01),不稳定心绞痛组又长于稳定性心绞痛组(P<0.05)。治疗后心肌缺血减轻,QTd和QTcd明显缩短。结论:QTd和QTcd延长与冠心病心绞痛患者的心肌缺血及其病情严重程度呈正相关,鲁南欣康在改善心肌缺血的同时,可使QTd及QTcd缩短。

Objective: To investigate the relationship between the variation of QT dispersion (QTd) and QT corrected dispersion (QTcd) and the degree of myocardial ischemia and effects of drugs on QTd and QTcd. Methods: All 68 patients with angina pectoris were classified into stable (35 cases) and unstable (33 cases) angina groups. Synchronous 12 leads electrocardiograph were recorded and QT intervals were measured. QTd was calculated by Qtmax-Qtmin and heart rate QTcd could be got by Bazets Formula. The variations of myocardial ischemia, QTd, and QTcd were observed after the treatment with Isosorbide Mononitrate Injection (IMI). Results: QTd and QTcd in two angina groups were significantly longer than that in control group (P<0.01). QTd and QTcd in unstable angina group were longer than that in stable angina group (P< 0.05). The degree of myocardial ischemia relieved, and QTd and QTcd significantly shortened after the treatment with IMI. Conclusion: Longer QTd correlates to the degree of myocardial ischemia in patients with angina pectoris. Treatment with IMI will relieve myocardial ischemia and shorten QTd and QTcd.