老年心肌梗死患者跨壁复极离散度增大与恶性室性心律失常预后的关联分析

Analysis on relationship between transmural dispersion of repolarization increase and prognosis of malignant ventricular arrhythmia in patients with myocardial infarction

目的研究T波峰末-间期老年心肌梗死患者跨壁复极离散度增大与室性心律失常、梗死程度及冠脉事件发生的关系,为老年心肌梗死预后评估提供指导意见。方法选取该院心内科老年急性心肌梗死(AMI)患者120例作为研究对象,其中男73例,女47例,平均年龄(62.37±11.34)岁。另选取其他心脏疾病的老年患者76例作为对照组,其中男42例,女34例,平均年龄(59.56±12.64)岁。分析不同分组患者T波峰末-间期及离散度和校正心率后T波峰末-间期及离散度。结果入院时对照组与AMI组间、AMI组内急性期患者与恢复期患者的T波峰末-间期、离散度及校正心率后T波峰末-间期、离散度方面比较,差异具有统计学意义(P<0.01);AMI组不同室性心律失常患者校正心率前后T波峰末-间期、离散度比较,差异具有统计学意义(P<0.01);AMI组前间壁、前壁、下壁、高侧壁与多支梗死患者之间的校正心率前后T波峰末-间期、离散度比较,差异具有统计学意义(P<0.01);校正心率后不同T波峰末-间期患者死亡及入院时冠心病事件发生情况比较,差异具有统计学意义(P<0.01)。结论 T波峰末-间期与恶性心律失常发生关系密切,对AMI老年患者的近期预后具有重要的预测价值。

Objective To explore the relationship between the increase of transmural dispersion of repolarization with ventricular arrhythmia,myocardial infarction degree and coronary events in elderly patients with myocardial infarction at T peak -T end interval in order to provide the guidance instruction for the assessment of prognosis of elderly myocardial infarction. Methods One hundred and twenty cases of senile myocardial infarction in the cardiology department of our hospital were selected, including 73 males and 47 females, the average age was （62.37 ± 11.34） years old. In addition, 76 elderly cases of other heart disease were select- ed as the control group,including 42 males and 34 females,the average age was （59.56 ± 12.64） years old. The T peak-T end in- terval,dispersion and T peak -T end interval and dispersion after correcting the heart rate in different groups were analyzed. Results The T peak-T end interval,dispersion and T peak -T end interval and dispersion after correcting the heart rate had statistical differences between the control group and AMI group at admission and between the acute stage and recovery stage in the AMI group （P〈0.01）.the T peak -T end interval and dispersion before and after correcting the heart rate had statistical differences among the patients with different ventricular arrhythmia （P〈0.01） ;the T peak -T end interval and dispersion before and after cor- recting the heart rate had statistical differences among the patients with anterior lateral wall. anterior wall. inferior wall. high lateral wall and multiple vessels infarction （P〈0. 01） ;the case death after correcting the heart rate in different degrees and coronary event occurrence at admission had statistical difference （P〈0.01）. Conclusion The T peak-T end interval has a close relation with malignant arrhythmia occurrence,which has an important predictive value for the short term prognosis in elderly patients with AMI.