急性心肌梗死48例qt离散度临床意义

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1、急性心肌梗死48例QT离散度临床意义【摘要】　　目的探讨急性心肌梗死患者溶栓治疗前后QT离散度及校正的QT离散度的变化与恶性心律失常、猝死等心脏事件发生率的相关性。方法将48例急性心肌梗死患者溶栓治疗后根据其是否再通分为两组，分别观察溶栓治疗前后的QT离散度及校正的QT离散度，记录其恶性心律失常、猝死等心脏事件的发生率，并进行统计分析。结果经溶栓治疗后急性心肌梗死患者再通者29例，未通者19例。溶栓再通组于再通后24h内QT离散度迅速降至正常水平，未通组于溶栓治疗后7d方逐渐接近正常水平。溶栓治疗第3d末，再通组QT离散度及校正的QT离散度与治疗前比较差异均有极显著性（t＝2.825

2、，2.719，P均＜0.01），未通组与治疗前比较均无显著性差异（P＞0.05），两组间比较差异均有极显著性（t＝2.713，2.941，P均＜0.01）。心脏事件发生组QT离散度及校正的QT离散度均极显著高于未发生组（t＝2.819，2.691，P均＜0.01）。结论QT离散度与心肌梗死后局部心肌复极电活动的不均一性有关；QT离散度及校正的QT离散度越大，恶性心律失常发生率越高。【关键词】急性心肌梗死；QT离散度；校正的QT离散度；心脏事件　　【Abstract】ObjectiveToexplorethedependablitybetweenpreandposttreatmen

3、tQTdispersionorcorrected8QTdispersionchangesandtheincidenceofscuchhearteventsasmalignantarrhythmiaandsuddendeathetcinpatientswithacutemyocardialinfarctionbeforeandafterthrombolysistreatment.Methods48patientsweredividedintotwogroupsaccordingtowhetherrecanalizationornot,QTdispersionorcorrectedQTd

4、ispersionobservedandincidencesofscuchhearteventsasmalignantarrhythmiaandsuddendeathrecordedandstatisticallyanalyzed.ResultsAfterthrombolysistreatment,recanalizationpatientswere29andnoncanalization19.QTdispersionquicklyloweredtonormallevelwithin24hourafterrecanalizationinthethrombolysisrecanali

5、zationgroupanddidonthe7thdayafterthrombolysistreatmentinthenoncanalizationgroup.Attheendofthe3rddayofthrombolysistreatment,therewereverysignificantdifferencesinQTdispersionorcorrectedQTdispersioncomparedwithpretreatmentintherecanalizationgroup(P<0.01),nodifferenceinthenoncanalizationgroup(

6、P>0.05)andintergroupcomparisonsshowedverysignificantdifference(P<0.01).QTdispersionorcorrectedQTdispersionwereverysignificantlyhigherinthehearteventdevelopinggroupthaninthenondevelopinggroup(P<0.01).ConclusionQTdispersionisrelatedtoheterogeneityoftopoCM8repolarizationactivityfollowi

7、ngmyocardialinfarction;thelargeristheQTdispersionorcorrectedQTdispersion,thehighertheincidenceofmalignantarrhythmogenesis.　　【Keywords】Acutemyocardialinfarction;QTdispersion;correctedQTdispersion;heartevent　　QT间期离散度（QTd）可反映心室的复极情况，