再灌注治疗对急性心肌梗死患者QRS离散度的影响

Effects of reperfusion therapy on QRS dispersion in acute myocardial infarction

目的:探讨成功静脉溶栓或经皮腔内冠状动脉成形术（PTCA）治疗对急性心肌梗死患者QRS离散度（QRSd）的影响。方法:对象为60例发病6小时内成功进行静脉溶栓或PTCA术治疗的急性心肌梗死患者。其中静脉尿激酶溶栓44例,直接接受PTCA及冠状动脉内支架术治疗16例。60例患者均接受体表12导同步心电图QRSd的检测。结果:与治疗前相比,成功再灌注（静脉溶栓或PTCA术）治疗的急性心肌梗死患者的QRSd明显减少（P<0.05）。结论:成功再灌注治疗可改善急性心肌缺血及心室除极的不一致,从而明显减小QRSd。

Objective: To study the effects of the method used to achieve early coronary reperfusioin (intravenous thrombolysis or percutaneous transluminal coronary angioplasty) on QRS dispersion in acute myocardial infarction (AMI). Methods: Sixty patients with AMI were studied. Reperfusion was successfully achieved by intravenous thrombolysis in 44 AMI patients and by primary angioplasty in 16 AMI patients within 6 h of symptom onset. The standard 12-lead synchronous ECG was recorded before and after intravenous thrombolysis or primary angioplasty. Maximum QRS (QRS), minimal QRS (QRSmin) and QRS dispersion (QRSd) were measured. Results: After intravenous thrombolysis or primary angioplasty, QRSd and QRSmax were significantly shortened (P<0. 05). but QRSnun showed no significant change (P>0. 05). Conclusion: QRSd obviously decreased after reperfusion therapy due to improvement of myocardial acute ischemia and inhomogeneity of myocardial depolarization times in AMI patients.