急性心肌梗死急诊PCI术后早期T波倒置与QT离散度的关系

Relationship between early T wave inversion and QT dispersion for acute myocardial infarction after PCI

目的探讨急性心肌梗死(AMI)急诊经皮冠状动脉介入术(PCI)术后早期T波倒置与QT离散度(QTd)的关系。方法选取我院2017年1月至2018年6月收治的130例AMI患者为研究对象,将PCI术后24h出现T波倒置患者(90例)选为试验组,将PCI术后24h未出现T波倒置患者(40例)选为常规组。比较两组患者的再灌注率、心功能、QTd、QTcd及心血管事件发生情况。结果试验组患者的再灌注率为91.11%,显著高于常规组的70.00%(P<0.05)。术后1、6个月,试验组LVEF均显著高于常规组,LVEDd均显著小于常规组(P<0.05);术后12h,试验组患者QTd、QTcd明显低于常规组(P<0.05)。试验组心血管事件总发生率显著低于常规组(P<0.05)。结论当通过PCI术后早期T波倒置评估AMI患者的病情预后和危险层级时,QTcd、QTd变化具有重要作用。因此,临床中应加强术后对患者心电图T波和QTd的监测,以达到对高危患者的有效治疗。

Objective To explore the relationship between early T wave inversion and QT dispersion(QTd)for acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods A total of 130 patients with AMI in our hospital from January 2017 to June 2018 were selected as the study objects.Among them,90 patients with T wave inversion at 24 h after PCI were selected as experimental group,and 40 patients without T wave inversion at 24 h after PCI were selected as conventional group.The reperfusion rate,cardiac function,QTd,QTcd,and cardiovascular events were compared between the two groups.Results The reperfusion rate of the experimental group was 91.11%,which was significantly higher than 70.00%of the conventional group(P<0.05).At 1,6 months after operation,the LVEF of the experimental group was significantly higher than that of the conventional group,and LVEDd of the experimental group was significantly smaller than that of the conventional group(P<0.05).At 12 h after operation,the QTd and QTcd of the experimental group were significantly lower than those of the conventional group(P<0.05).The total incidence of cardiovascular events in the experimental group was significantly lower than that in the conventional group(P<0.05).Conclusion The changes of QTcd and QTd play an important role in evaluating the prognosis and risk level of patients with AMI by early T wave inversion after PCI.Therefore,monitoring of T wave and QT dispersion of patients should be strengthened to achieve effective treatment for high-risk patients in the clinic.