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目的 :对照观察直接PTCA和择期PTCA对急性心肌梗死 (AMI)患者QTd和QTcd的不同影响。方法 :对 3 6例直接PTCA使病变血管血流达TIMI3级的AMI患者 ,测量其术量、术后 2h、48h12导联心电图的QTd和QTcd ,并与 48例择期PTCA的AMI患者比较。同时与 5 0例冠状动脉造影正常者对照。结果 :AMI患者QTd和QTcd对照正常组有显著差异 ,有室性心律失常的AMI患者QTd和QTcd明显高于无室性心律失常的患者 (P <0 0 5 ) ,直接PTCA和择期PTCA两组AMI患者与正常对照组QTd和QTcd均有显著性差异 ,两者的QTd和QTcd均有明显的下降 ,但前者下降的幅度远远大于后者 ,两者差异显著 ,有统计学意义。结论 :AMI患者不论直接PTCA和择期PTCA均可降低患者QTd和QTcd ,以减少心律失常的发生 ,但直接PTCA明显优于择期PTCA。
Objective: To observe the different effects of direct PTCA and elective PTCA on QTd and QTcd in patients with acute myocardial infarction (AMI). Methods: Thirty-six AMI patients with TIMI3 grade angiogenic blood flow were measured by direct PTCA. The QTd and QTcd of lead electrocardiogram at 2 hours and 48 hours after operation were compared with 48 cases of AMI patients undergoing elective PTCA. At the same time with 50 normal coronary angiography control. Results: There was a significant difference between QTd and QTcd control group in AMI patients. The QTd and QTcd in AMI patients with ventricular arrhythmias were significantly higher than those in patients without ventricular arrhythmias (P <0.05). Both direct PTCA and elective PTCA There was a significant difference between QTd and QTcd in patients with AMI and normal control group, both QTd and QTcd were significantly decreased, but the former decreased much more than the latter, the difference was significant and statistically significant. Conclusion: Patients with AMI can reduce QTd and QTcd in both PTCA and PTCA directly to reduce arrhythmia, but direct PTCA is superior to elective PTCA.