【摘要】 目的探讨直接经皮冠状动脉介入治疗(PCI)对急性心肌梗死(AMI)QT离散度的影响及其临床意义。方法回顾性分析2001年1月~2004年12月在我院接受直接PCI且成功开通梗死相关血管的AMI患者228例。病例分AMI发病6h内(150例)和6h以上(78例)两组。测算和比较两组术前和术后第1天心电图QT间期、QT离散度、心率校正QT间期和心率校正QT离散度,并比较两组住院期间主要不良心血管事件(MACE)发生率。结果两组QT间期和心率校正QT间期术后与术前相比均无显著性差异;但术后QT离散度和心率校正QT离散度较术前显著减小(P<0·01),且发病6h以内组显著小于发病6h以上组(P<0·05);两组住院期间MACE发生率分别为14·6%和27·7%(P<0·05)。结论成功的介入治疗能显著减小心肌梗死患者的QT离散度,改善患者近期预后;介入治疗施行得越早则减小QT离散度和改善近期预后的效果越好。更多还原

【Abstract】 Objective To elucidate the effects of primary percutanious coronary intervention(PCI) on QT dispersion (QTd) in patients with acute myocardial infarction(AMI) and to find out its clinical significance. Methods Clinical data of 228 patients in whom the infarct-related artery was successfully recanalized by primary PCI for AMI were retrospectively analyzed. All the patients underwent emergenct percutaneous transluminal coronary angioplasty and subsequently coronary stenting. The time intervals from AMI onset to the infarct-related artery reflow were <or=6h in 150 patients and 6 to 12 hours in others. The electrocardiograms were recorded before and one day after PCI in the patients. QT intervals, QTd, and heart-rate-corrected QT intervals(QTc) and QTd (QTcd) were gauged and calculated. The mobidity of major adverse cardiovascular events(MACE) during hospitalization was analyzed as well as the above electrocardiogram parameters. Results In both the less-than-and the greater-than-6-hour group, QT and QTc after PCI were not significantly different from before PCI. But the QTd and the QTcd after PCI were remarkably decreased (all P values<0.01). Moreover, the QTd and QTcd in the less-than-6-hour group were significantly shorter than those in the greaterthan-6-hour group(all P values<0.05). And the in-hospital MACE morbidity was 14.6% and 27.7%,respectively(P<0.05). Conclusion Successful PCI could notably reduce QTd in patients with AMI and improve the short-term prognosis of AMI. The earlier the PCI was performed, the better the effects of reperfusion by PCI on reducing QTd and improving the prognosis.更多还原