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目的 探讨冠心病 (CHD)患者经皮冠状动脉成形术 (PTCA)后对QT离散度 (QTd)及较正QT离散度 (QTcd)的影响。方法 经选择性冠状动脉造影 (CAG)确诊为冠心病 ,且行PTCA或 (及 )冠脉内植入支架 (CASl)患者 12 9例 ,根据诊治结果分为单支血管病变组 35例 ;二支血管病变组 5 0例 ;三支血管病变组 4 4例 ;另有冠脉造影正常组 86例共四组。取术前 1周及术后 4 8h内的心电图测量QTd及QTcd。结果 冠脉病变各组术后QTd、QTcd较术前明显缩短 (P <0 .0 1)。冠脉病变各组术前QTd及QTcd与正常组造影前QTd及QTcd之间存在显著性差异 (P <0 .0 1) ,QTd、QTcd随着血管病变支数增多变异增大 (P <0 .0 5 ) ,测量QTcd特异性高。结论 心肌缺血可引起QTd、QTcd增加 ,随着血管病变支数增多变异增大 ,PTCA术后QTd、QTcd明显缩短 ,QTcd特异性高。
Objective To investigate the effects of percutaneous transluminal coronary angioplasty (PTCA) on QTd and QTcd in patients with coronary heart disease (CHD). Methods One hundred and nineteen patients with coronary artery disease underwent coronary angiography (CAG) and PTCA (or) coronary stent implantation (CASl) were enrolled. According to the results of diagnosis and treatment, 35 patients were divided into single vessel disease group, 50 cases of vascular disease group; 34 cases of three vascular disease group; another group of 86 cases of normal coronary angiography group of four. The electrocardiogram QTd and QTcd were measured within 1 week before operation and within 48 hours after operation. Results The postoperative QTd and QTcd of coronary lesions were significantly shorter than those before operation (P <0.01). There were significant differences in QTd and QTcd between preoperative QTd and QTcd before and after coronary angiography (P <0.01), while QTd and QTcd increased with the number of vascular lesions .0 5), measuring QTcd specificity high. Conclusions Myocardial ischemia can lead to the increase of QTd and QTcd. With the increase of the number of vascular lesions, the QTd and QTcd are significantly shortened and the QTcd is highly specific.