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目的 研究急性心肌梗塞 (AMI)患者应用直接经皮腔内冠状动脉成形术 (PTCA)对 QT离散度(QTd)的影响。方法 回顾 95例 AMI患者 ,通过测量入院时及入院后不同时间心电图 ,计算校正 QTd(QTcd)。对比分析其中 68例 PTCA再通患者 (PTCA组 )与 2 7例未行 PTCA或溶栓患者 (对照组 )不同时间 QTd与 QTcd的变化。结果 PTCA组再通即刻 QTd、QTcd较再通前明显延长 (P<0 .0 1 ) ,2小时后恢复到入院时水平 ,4小时后较入院时明显缩短 (P<0 .0 1 ) ,以后 2 4小时内相对稳定。对照组入院后 2 4小时内 QTd、 QTcd变化不大 (P>0 .0 5 )。结论 AMI患者应用成功的 PTCA治疗可以缩短心室复极的 QTd,但再灌注即刻可加重心室复极的 QTd
Objective To investigate the effect of direct percutaneous transluminal coronary angioplasty (PTCA) on QT dispersion in patients with acute myocardial infarction (AMI). Methods Ninety-five AMI patients were reviewed. QTd (QTcd) was calculated by measuring the electrocardiogram at admission and at different times after admission. The changes of QTd and QTcd in 68 patients with PTCA recanalization (PTCA group) and 27 patients without PTCA or thrombolytic therapy (control group) were analyzed. Results QTd and QTcd in PTCA group were significantly longer than those before reoperation (P <0.01), returned to the level of admission after 2 hours, shortened significantly after 4 hours (P <0.01) After 24 hours relatively stable. QTd and QTcd changed little in 24 hours after admission in the control group (P> 0.05). Conclusions Successful PTCA can shorten the QTd of ventricular repolarization in AMI patients, but QTd of ventricular repolarization can be aggravated immediately after reperfusion