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目的探讨发病3 h内的急性ST段抬高性心肌梗死(STEMl)行急诊冠状动脉介入治疗(PCI)与静脉溶栓(尿激酶)疗法对QT离散度(QTd)的影响。方法入选68例发病3 h以内STEMI的患者随机分为2组,即急诊PCI组与静脉溶栓组。观察急诊PCI组、静脉溶栓组在治疗前及治疗后24 h的QTd变化,同时对两者进行对比分析。结果急诊PCI组QTd从术前的(78.2±10.8)ms降至术后的(39.7±6.16)ms(P<0.01),静脉溶栓组QTd从由溶栓前的(77.9±10.3)ms降至溶栓后的(43.6±7.1)ms(P<0.01)。两者治疗后进行对比QTd差异有统计学意义(P<0.05)。结论对于发病3 h内STE-MI患者急诊PCI降低QTd优于静脉溶栓疗法。急诊PCI术后QTd缩短更显著,表明急诊PCI疗效更佳。
Objective To investigate the effect of acute coronary intervention (STEMI) on QTd in patients with acute ST-segment elevation myocardial infarction (STEMI) within 3 hours after onset of acute coronary syndrome (PCI) and intravenous thrombolysis (urokinase). Methods A total of 68 patients with STEMI within 3 hours of onset were randomly divided into two groups: emergency PCI group and intravenous thrombolysis group. To observe the changes of QTd in emergency PCI group and intravenous thrombolysis group before and 24 h after treatment, and to compare the two. Results QTd in emergency PCI decreased from 78.2 ± 10.8 ms to 39.7 ± 6.16 ms postoperatively (P <0.01). QTd in intravenous thrombolysis decreased from 77.9 ± 10.3 ms before thrombolysis (43.6 ± 7.1) ms after thrombolysis (P <0.01). The difference between the two groups after treatment was statistically significant (P <0.05). Conclusions PCI is better than intravenous thrombolysis in emergency PCI for patients with STE-MI within 3 hours of onset. QTd shortening after emergency PCI is more significant, indicating that emergency PCI is more effective.