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目的观察老年急性心肌梗死(AMI)患者溶栓前后QT离散度(QTd)的变化,分析其与室性心律失常的关系。方法测量40例老年AMI患者的QT间期,计算其QTd及校正后的QT离散度(QTdc)。结果①AMI组QTd及QTdc大于100 ms患者中,室性心动过速(室速)、心室颤动(室颤)发生率明显高于QTd、QTdc小于100 ms者(73.0%及6.8%,P<0.001);②溶栓再通组溶栓后QTd及QT-dc[(分别为(51.2±21.4)及(62.8±21.9)ms]较溶栓前缩短[分别为(77.4±21.1)及(90.0±30.6)ms],差异均有显著性(P<0.05);未再通组溶栓前后QTd及QTdc差异无显著性(P>0.05)。结论老年AMI患者QTd、QTdc延长者室速及室颤发生率增高,溶栓后QTd及QTdc缩短提示溶栓后血管再通。
Objective To observe the changes of QTd before and after thrombolysis in elderly patients with acute myocardial infarction (AMI) and analyze its relationship with ventricular arrhythmia. Methods QT interval was measured in 40 elderly patients with AMI. QTd and corrected QT dispersion (QTdc) were calculated. Results ①The incidences of ventricular tachycardia and ventricular fibrillation were significantly higher in patients with AMI than those with QTd and QTdc less than 100 ms after QTd and QTdc were less than 100 ms (73.0% vs 6.8%, P <0.001) ); (2) The QTd and QT-dc [(51.2 ± 21.4 and 62.8 ± 21.9) ms, respectively, after thrombolysis and thrombolysis were shorter than those before thrombolysis (77.4 ± 21.1 and 90.0 ± 30.6) ms] (P <0.05). There was no significant difference in QTd and QTdc before and after thrombolysis in the non-recanalization group (P> 0.05) .Conclusion The QTd and QTdc exacerbation ventricular tachycardia and ventricular fibrillation The incidence increased, thrombolytic QTd and QTdc shortened after thrombolysis recanalization.