论文部分内容阅读
目的：分析急性心肌梗塞（AMI）患者早期QT离散度（QTd）及溶栓治疗前后QTd、QTcd的变化，探讨其在AMI时室性心律失常预测及溶栓疗效评定中意义。方法：测量98例AMI患者常规12导联心电图QT间期及其中40例经溶栓治疗者溶栓前后QT间期，计算其QTd及校正后的QT离散度（QTcd），并设正常对照组。结果：①AMI组QTd、QTcd均明显大于正常对照组（P＜0．001）；②室性心律失常者QTd、QTcd较无心律失常者均有显著延长（P＜0．001），且与恶性程度有关；③AMI患者QTd、QTcd大小与梗塞部位有关，其增大程度依次为复合壁＞广泛前壁＞前壁＞前间壁＞下壁。④溶栓再通组（24例）溶栓后2h、24h、3d、1W的QTd、QTcd较溶栓前缩短，均有统计学意义；未通组（16例）溶栓前后QTd及QTcd无此变化。（P＞0．05）溶栓后，未通组与再通组相比QTd、QTcd均有显著性差异。结论：AMI的QTd、QTcd延长者，室性心律失常事件发生率增高，可作为预测室性心律失常的指标；溶栓后，QTd、QTcd缩短，提示溶栓后血管再通，故亦可作为溶栓后梗塞血管是否再通的判断指标。
OBJECTIVE: To analyze the changes of QTd and QTd and QTcd before and after thrombolytic therapy in patients with acute myocardial infarction (AMI), and to explore its significance in the prediction of ventricular arrhythmia and thrombolytic therapy in AMI. Methods: The QT interval of 12-lead electrocardiogram (ECG) and the QT interval of 40 patients with thrombolytic therapy before and after thrombolytic therapy were measured in 98 patients with AMI. QTd and QT dispersion after correction were calculated. The normal control group . Results: ① QTd and QTcd in AMI group were significantly higher than those in normal control group (P <0.001); ② QTd and QTcd in patients with ventricular arrhythmia were significantly longer than those without arrhythmia (P <0.001) The degree of related; ③ AMI patients with QTd, QTcd size and infarction related to the increase in order of complex wall> extensive anterior wall> anterior wall> anterior wall> inferior wall. Thrombolytic recanalization group (24 cases) QTd and QTcd at 2h, 24h, 3d and 1w after thrombolysis were shorter than those before thrombolysis, both of which were statistically significant; QTd and QTcd before and after thrombolysis This change. (P> 0.05), the QTd and QTcd of failed group and recanalization group were significantly different after thrombolysis. Conclusions: The incidence of QTd and QTcd extenders and ventricular arrhythmia in AMI is increased, which can be used as an index to predict ventricular arrhythmia. After thrombolysis, QTd and QTcd are shortened, suggesting recanalization of blood vessels after thrombolysis. Therefore, Thrombolytic thrombosis after the judge whether the recanalization index.