糖尿病并急性心肌梗死溶栓对Q-T离散度的影响

Influence of thrombolysis on Q-T dispersion in patients with diabetes accompanied by AMI

目的:探讨糖尿病患者急性心肌梗死(AMI)静脉溶栓治疗对Q-T离散度的影响及意义。方法:观察48例糖尿病并AMI发病6小时内患者的静脉溶栓治疗,按溶栓后冠脉有无再通分为再通组(32例)和未通组(16例),测定溶栓前和溶栓后2小时的Q-T离散度。结果:溶栓前两组AMI患者的Q-T离散度无差异,溶栓后Q-T离散度再通组明显低于未通组,有显著差异(P<0.05)。Lown氏3级以上室性心律失常:溶栓前两组无显著差异(P>0.05),溶栓后再通组的显著低于未通组(P<0.01)。结论:糖尿病患者AMI早期有效的溶栓治疗可缩短Q-T离散度,改善心肌电稳定性和植物神经功能,并减少恶性心律失常的发生;Q-T离散度具有预测恶性心律失常发生的价值。

ve: To study the influence of thrombolysis therapy on Q-T dispersions in patients with diabetes accompanied by AMI. Methods: Forty-night patients with diabetes accompanied by AMI performed the thrombolysis within 6 hours, according to the condition of coronary artery after thrombolysis, all the patients were divided into reperfusion group (32 cases) and obstructed group (16 cases), Q-T dispersions were measured before and after thrombolysis. Results: No difference was noted for Q-T dispersions in both groups before thrombolysis. After thrombolysis the Q-T dispersions of reperfusion group were significantly lower than those of obstructed group (P< 0. 05); ventricular arrhythmia of Lown grade 3 and more before thrombolysis had no difference in two groups (P> 0.05), but the reperfusion group was much lower than the obstructed group after thrombolysis (P<0. 01) Conclusion: Effective thrombolysis therapy for AMI cases in early stage can reduce the Q-T dispersions, amend the electric stability of myocardium and the function of vegetative nerve, decrease the occurrence of malignant ventricular arrhythmia. Q-T dispersions possess the predictive value of malignant ventricular arrhythmia.