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本文观察了45例静脉溶栓治疗的急性心肌梗塞(AMI)病人,测量其溶栓前及溶栓后2h 的 QT 离散度(QTd)。结果表明:①溶栓后2h 的 QTd 30.00±22.80ms 较溶栓前65.00±26.61ms明显减少(P<0.01)。②溶栓后冠脉再通组 QTd 27.14±23.51ms 与来通组相比35.00±21.29ms 无显著差异(P>0.05)。③溶栓后 QTd≥60ms 者病死率42.86%明显高于 QTd<60ms 者2.63%(P<0.01);且死亡者溶栓前后 QTd 下降幅度(由61.25±29.55ms 降至57.50±12.58ms)明显低于存活者(由65.38±26.68ms 降至27.25±21.81ms)(P<0.01)。结果提示:溶栓治疗不论冠脉能否再通,均可使 AMI 病人的 QTd 明显减少;且溶栓前后 QTd 下降幅度及溶栓后 QTd 大小与病人预后密切相关。
In this paper, 45 patients with acute myocardial infarction (AMI) treated with intravenous thrombolysis were enrolled and their QTd before and 2h after thrombolysis were measured. The results showed that: (1) QTd 30.00 ± 22.80ms at 2h after thrombolysis was significantly decreased compared with 65.00 ± 26.61ms before thrombolysis (P <0.01). ②There was no significant difference between QTd 27.14 ± 23.51ms in coronary recanalization group and 35.00 ± 21.29ms in control group after thrombolysis (P> 0.05). ③The mortality of QTd≥60ms after thrombolysis was 42.86%, which was significantly higher than that of QTd <60ms (2.63%) (P <0.01). The decrease of QTd before and after thrombolysis was significantly decreased from 61.25 ± 29.55ms to 57.50 ± 12.58ms Below the survivors (from 65.38 ± 26.68 ms to 27.25 ± 21.81 ms) (P <0.01). The results suggest that the thrombolytic therapy can reduce the QTd of patients with AMI regardless of the recanalization of coronary artery. The decrease of QTd and the QTd after thrombolysis are closely related to the prognosis of patients.