冠脉支架置入术后肌钙蛋白T增高对QT离散度的影响

Effect of troponin-T elevation on QT dispersion after stenting

目的 观察冠脉支架置入术后微小心肌损伤对心肌复极电生理 (QT离散度 )的影响。方法 82例行单个冠脉支架置入术的冠心病患者 ,于术前 1天及术后 4周行QT离散度 (QTd)测定 ,术前 1h及术后 2 4h行血心肌钙蛋白T(CTnT)及肌酸激酶同工酶 (CK MB)测定。根据其术后CT nT浓度分为CTnT(+ )组 (19例 )及CTnT(-)组 (63例 ) ,分别比较其治疗前后QTd的变化。结果 CTnT(+ )组术前、术后QTd分别为 (61 6± 11 7)ms和 (53 3± 10 4)ms ,P <0 0 1;CTnT(-)组术前、术后QTd分别为 (60 4± 14 8)ms和 (46 2± 12 4)ms ,P <0 0 0 1。同期两组比较 ,CTnT(-)组术后的QTd较CTnT (+ )组明显缩短 ,P <0 0 5,术前两组QTd无显著差异。结论 成功施行冠脉支架置入术后出现微小心肌损伤者 ,其心肌复极电生理受影响 ,QTd的改善受阻 。

Objectives To investigate the effect of minor myocardial damage on QT dispersion (QTd) after coronary stenting. Methods Eighty two patients undergoing coronary stenting (CS) were evaluated with blood levels of cardiospecific troponin T (CTnT) and creatine kinase MB (CK MB) before and 24h after the procedures The patients were divided into 2 groups depending on the blood levels of CTnT: the CTnT (+) group ( n =19) and the CTnT (-) group ( n =63) The QTd of the patients were measured 24 h before and 4wk after CS. Results The QTd for the CTnT (+) group were (61 6±11 7) ms before CS and (53 3±10 4) ms after CS, respectively ( P <0 01); The QTd for the CTnT (-) group were (60 4±14 8) ms before CS and (46 2±12 4) ms after CS, respectively ( P <0 001) Comparison between 2 groups show that QTd in CTnT (+) group after CS was remarkably higher than that in CTnT(-) group ( P <0 05); The rest had no statistic meaning. Conclusions Some patients have minor myocardial damage after successful coronary stenting, and this may hold back the improvement of QTd in the patients.