AMI患者急诊PTCA+支架植入术对QT离散度的影响

Effects of acute percutaneous coronary angioplasty and stent implantation on QT dispersion

目的 观察 2 6例急性心肌梗死 (AMI)患者梗死相关血管 (IRA)早期再灌注对QT离散度 (QTd)的影响。方法 对 2 6例AMI患者予急诊冠状动脉造影 ,对IRA予急诊PTCA +支架术 ,在术前及术后 2 4小时内分别记录体表 12导联同步心电图 ,测量QTd ,并监测严重心律失常发生情况。结果 AMI患者行急诊PTCA +支架术后 ,IRA开通率 10 0 % ,所有病人IRA血流达TIMIⅢ级。QTd从术前的 ( 78 6± 17 4 )ms降至术后的 ( 4 8 6± 14 8)ms(P <0 0 1)。 7例术前有恶性心律失常 ,其QTd明显高于无心律失常的患者 ( 82 3± 15 6)术后QTd降至 ( 4 9 8± 13 7) ,室性心律失常消失。结论 急性PTCA +支架术可显著降低QTd ,IRA早期再灌注可减少危险性心律失常的发生。

ObjectiveToevaluatetheeffectsofearlyreperfusionofinfarct relatedartery(IRA)afteracutepercuta neouscoronaryangioplasty(PTCA)andstentimplantationonQTdinpatientswithacutemyocardialinfarction(AMI) Methods 2 6AMIpatientsunderwentacutecoronaryangiography ,andacutePTCAandstentimplantationforIRAs QTd wasmeasuredusing 12 leadelectrocardiographybeforeand 2 4hafterprocedure ,Meanwhilesevereventriculararrhythmia weremonitored ResulteReopeningrateofIRAsafteracutePTCAandstentwas 10 0 % (TIMIflow 3grade) QTdde creasedfrom (78 6± 17 4 )msatbaselineto (4 8 6± 14 8)ms (P <0 0 1) Beforetheprocedure ,sevenAMIpatients wereassociatedwithmalignantventriculararrhythmiasandtheQTdwassignificantlylongerinthesepatientascompared withthosewithoutventriculararrhythmia(82 3± 15 6vs4 9 8± 13 7,P <0 0 5 ) Aftertheprocedure ,alloftheseven patientswereassociatedwithasignificantreductionofQTd ,anddisappearanceofventriculararrhythmia Conclusion EarlyreperfusionofIRAsbyPTCAandstentimplantationisassociatedwiththereductionofQTdandthedecreasedrisk ofventriculararrhythmiasinAMIpatients