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目的:探讨溶栓治疗对急性心肌梗塞(AMI)患者 QTc 间期的影响。方法:针294例 AMI 患者分为溶栓再通组(157例)和未溶栓组(137例),观察两组 QTc 间期的变化以及与 CK-MB 动态变化关系。结果溶栓治疗前两组的 QTc 间期均延长 CK-MB 均升高,但两组比较均无显著性差异(P>0.05)。溶栓再通组溶栓后第1、2、4天的 QTc 间期与未溶栓组比较也无显著性差异(P>0.05);而第6、8天两组分别为448±48与483±54(P<0.05);437±44与476±46(P<0.05)未溶栓组 QTc 间期比溶栓再通组显著延长。并且溶栓再通组QTc 间期的最大峰较未溶栓组提前3天出现。而且两组 QTc 间期变化与 CK-MB 变化均呈显著正相关关系。(r=+0.7804,P<0.05,r=+0.9498,P<0.01)。结论:溶栓治疗可以缩短 AMI 患者 QTc 的最大峰值出现时间,且与 CK-MB 呈显著正相关关系,故 QTc 的动态变化对判断溶栓治疗效果具有一定意义。
Objective: To investigate the effect of thrombolytic therapy on QTc interval in patients with acute myocardial infarction (AMI). Methods: A total of 294 AMI patients were divided into thrombolytic group (157 cases) and no thrombolysis group (137 cases). The relationship between QTc interval and CK-MB in the two groups was observed. Results Both QTc interval and CK-MB of the two groups before thrombolytic therapy were increased, but there was no significant difference between the two groups (P> 0.05). There was no significant difference in the QTc interval between the first, second and fourth day after thrombolysis and thrombolytic therapy (P> 0.05), while the QTc interval between the first and second thrombolytic group was 448 ± 48 and 483 ± 54 (P <0.05); 437 ± 44 and 476 ± 46 (P <0.05). The QTc interval was significantly longer than that in the thrombolytic group without thrombolysis. And thrombolysis recanalization group QTc maximum peak compared with no thrombolytic group 3 days in advance. And QTc interval changes and CK-MB changes were significantly positive correlation between the two groups. (r = +0.7804, P <0.05, r = +0.9498, P <0.01). Conclusion: Thrombolytic therapy can shorten the peak time of QTc in patients with AMI and have a significant positive correlation with CK-MB. Therefore, the dynamic changes of QTc have some significance in judging the effect of thrombolytic therapy.