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目的 对 3 7例急性心肌梗死 (AMI)者溶栓治疗前后QTcd作观察 ,研究QTcd的临床意义。方法 于溶栓治疗前后行标准 12导联心电图检查 ,测量QTcd且与正常人心电图进行比较 ,以溶栓治疗血管再通标准判定是否成功。结果 AMI组 (A组 )溶栓前与对照组 (B组 )QTcd有显著差异 ( 76.4± 18.5 )ms与 ( 3 6.1± 10 .3 )ms ,P <0 0 1。溶栓有效组 (A1 组 )QTcd于 2h左右后显著降低 ( 5 0 4± 17 7)ms与 ( 78 5± 10 9)ms ,P <0 0 5 ,无效组 (A2 组 )则QTcd恢复较慢。 8例发生室颤者的QTcd明显高于无室颤组 ( 110 6± 19 2 )ms与 ( 76 7± 16 1)ms,P <0 0 0 1,其中 5例再通后室颤消失 ,QTcd明显下降 ( 69 4± 11 2 )ms。结论 溶栓成功可明显降低QTcd ,减少严重室性心律失常的发生
Objective To investigate the clinical significance of QTcd before and after thrombolytic therapy in 37 acute myocardial infarction (AMI) patients. Methods Before and after thrombolytic therapy, standard 12-lead electrocardiogram was performed, QTcd was measured and compared with normal people’s electrocardiogram to determine whether the standard of thrombolysis recanalization was successful. Results There were significant differences (76.4 ± 18.5) ms and (36.1 ± 10.3) ms, P <0.01 before QTcd in AMI group (group A) and control group (group B) QTcd in the thrombolytic group (A1 group) decreased significantly (54 ± 17 7) ms and (78 ± 10 9) ms after 2h, P <0 05, while in the ineffective group (A2 group), QTcd recovered more SLOW. QTcd in 8 patients with VF was significantly higher than that in patients without VF (110 6 ± 19 2) ms and (76 7 ± 16 1) ms, P <0.01. Among them, 5 patients recurred after VF disappeared, QTcd decreased significantly (69 4 ± 11 2) ms. Conclusion Successful thrombolytic therapy can significantly reduce QTcd and reduce the occurrence of severe ventricular arrhythmia