冠心病冠状动脉介入治疗前后QT离散度的比较

Comparison of QT dispersion changes after percutaneous transluminal coronary angioplasty and stenting in patients with coronary heart disease

目的 探讨成功的冠状动脉介入手术 (PTCA及冠状动脉内支架置入术 )对冠心病患者QT离散度 (QTd)的影响。方法 考察 2 5 2例冠心病患者成功进行介入手术前后十二导联同步心电图的结果 ,计算QTd和校正的QT离散度 (QTcd)并进行对比分析。结果 2 5 2例冠心病患者经PTCA或加支架植入术共处理的病变有 383处 ,除 2 8例外 ,术后QTd缩短明显 ;介入手术前后QTd及QTcd比较有显著性差异 (P <0 0 5 ) ;血流灌注术后均达到TIMIⅢ级与Ⅱ级 ,两组术前QTcd比较以及术后下降幅度无显著差异 (P >0 0 5 ) ;单支与多支病变术前QTcd无显著差异 (P >0 0 5 ) ,术后下降幅度则有显著差异 (P <0 0 5 )。结论 冠心病经成功的介入治疗后QT离散度明显减小 ,QT离散度可作为介入手术后心肌再灌注成功的一个参考指标。

Objectives To investigate the effects of successful percutaneous transluminal coronary angioplasty (PTCA) and stenting on QT interval dispersion (QTd) in patients with coronary heart diseases. Methods PTCA and stenting were successfully performed on 252 patients with coronary heart diseases. QTd and corrected QTd (QTcd) were obtained with a standard 12-lead ECG before and after PTCA+stent, and comparative analysis was carried out respectively. Results QTd and QTcd after PTCA+stent were reduced significantly compared to those before PTCT+stent (P<0.05). There were no significant difference in QTd and QTcd before PTCA+stent between single vessel lesion and multi-vessel lesion, but after PTCA+stent, QTd and QTcd in single vessel lesion were decreased significantly compared to those in multi-vessel lesion(P<0.05). Conclusions QTd and QTcd were decreased significantly after successful PTCA+stent because of the improvement of myocardial ischemia and hetemgeneous repolarization in coronary heart diseases. Thus, QTd and QTcd may be used as useful markers for myocardial re-filling after operation.