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目的分析87例急性心肌梗塞(AMI)尿激酶溶栓治疗再通和未通QT离散度(QTd)及其与恶性心律失常发生的关系。方法用常规方法测量87例AMI一周内心电图中任何一导联QTd;设30例正常对照,计算资料用均数±标准差表示(x±s),两组间均值比较用配对的t检验,组间阳性率比较采用χ2检验,P<0.05为差异显著。结果AMI组较对照组QTd延长,AMI尿激酶溶栓治疗再通组较未通组则短,均差异显著;AMI组QTd延长者发生室颤、室速,Ⅲ°-AVB明显低于未通组,均差异显著,且住院期间无死亡。结论QTd测定为AMI患者恶性心脏事件发生提供了一个有用的非浸入性心电学方法和判定指标;AMI患者住院期间发生恶性心律失常如果发现及时,诊断准确,处理得当,效果会令人满意。
Objective To analyze the relationship between recanalization and unopened QT dispersion (QTd) and the incidence of malignant arrhythmia in 87 patients with acute myocardial infarction (AMI) treated with urokinase thrombolysis. Methods The QTd of any lead in 87 patients with AMI within one week was measured by routine method. The 30 normal controls were used. The calculated data were expressed as mean ± standard deviation (x ± s) The positive rate between groups using χ2 test, P <0.05 was significant difference. Results The QTd of AMI group was prolonged compared with that of control group, but the AMI group was shorter than that of unreceived group, the ventricular fibrillation, ventricular tachycardia and Ⅲ ° -AVB were significantly lower in AMI group than those in AMI group Group, all significant differences, and no death during hospitalization. Conclusion The QTd measurement provides a useful noninvasive ECG method and evaluation index for the occurrence of malignant cardiac events in patients with AMI. Malignant arrhythmias during AMI patients’ hospitalization may be satisfactory if they are found timely, accurately and properly.