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本文对１０６例急性心肌梗塞（ＡＭＩ）经静脉尿激酶溶栓患者的ＱＴ离散度（ＱＴｄ）进行了动态对比分析，结果显示：①ＡＭＩ后ＱＤｄ呈动态演变。再通组（ｎ＝７４）与未通组（ｎ＝３２）在溶栓前及ＡＭＩ后１２ｈＱＴｄ无差别。成功的溶栓治疗促进ＱＴｄ的恢复，ＡＭＩ后２４ｈ时再通组的ＱＴｄ明显短于未通组（５４±２２ｍｓ时６８±２５ｍｓ，Ｐ＜０．０５），该差别在观察期间持续存在；②未通组恶性心律失常（室速及室颤）的发生率高于再通组（４０．６％对１８．９％Ｐ＜０．０５），且分布的时间长；③ＡＭＩ后不同时间恶性心律失常的发生率与ＱＴｄ呈明显正相关（ｒ＝０．９２，Ｐ＜０．０１）。上述结果提示，在ＡＭＩ溶栓失败的病例，应根据ＱＴｄ的演变，适当延长心电监护时间，使患者安全渡过相对较长的心电不稳定期
In this paper, 106 cases of acute myocardial infarction (AMI) intravenous urokinase thrombolysis QTd dynamic contrast analysis of the results showed: ① AMI QDd dynamic evolution. The recanalization group (n = 74) did not differ from the failed group (n = 32) before thrombolysis and at 12 h after AMI. The successful thrombolytic therapy could promote the recovery of QTd. The QTd of the reperfusion group was significantly shorter than that of the failed group at 24 hours after AMI (68 ± 25ms at 54 ± 22ms, P <0.05), and the difference persisted during the observation period. The incidence of malignant arrhythmia (ventricular tachycardia and ventricular fibrillation) in unobserved group was higher than that in recanalization group (40.6% vs 18.9%, P <0.05), and the distribution was prolonged; ③The malignant rhythm The incidence of abnormalities was positively correlated with QTd (r = 0.92, P <0.01). The above results suggest that in patients with AMI thrombolytic failure, QTd should be based on the evolution of the appropriate extension of ECG monitoring time, so that patients through a relatively long period of unstable electrocardiogram