【摘要】 目的 :探讨经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗急性心肌梗死(acute myocardial infarction,AMI)前后,患者QT离散度(QT dispersion,QTd)及T波峰末间期(T peak-T end interval,Tp-Te)的变化及意义。方法 :选择80例成功实施PCI术的AMI患者为AMI组;同期100例在本院体检健康者为对照组。分别记录PCI术前、术后2、4、8、24 h及3、5、7 d的心电图,测量各个时期的QTd和Tp-Te值并行统计学分析。PCI术后随访3个月,根据有无恶性心律失常(malignant arrhythmia,MA)分为心律失常组和非心律失常组,比较术前及术后第7天QTd和Tp-Te值。结果:AMI组QTd和Tp-Te值明显高于对照组(P<0.01)。AMI患者PCI治疗4 h后QTd和Tp-Te值显著减少(P<0.01)。心律失常组较非心律失常组QTd和Tp-Te值明显延长(P<0.01)。结论:AMI患者PCI治疗前后QTd和Tp-Te值显著减少。PCI能降低心肌复极离散度,提高心肌电稳定性,明显改善AMI患者预后。QTd和Tp-Te可作为预测AMI患者PCI术后发生恶性心律失常的敏感指标。更多还原

【Abstract】 Objective:To explore the application value of QT dispersion(QTd) and T peak-T end interval(Tp-Te) on patients with acute myocardial infarction(AMI) through percutaneous coronary intervention(PCI). Methods:80 patients with AMI that who had undergone PCI were assigned to the AMI group and the other 100 healthy people in our hospital in the same period as control. ECG were recorded during the period of PCI preoperative and postoperative 2 h,4 h,8 h,24 h,3 d,5 d and 7 d,and the values of QTd and Tp-Te were measured and analyzed. Following-up for 3 months,according to the presence of malignant arrhythmia 80 patients were divided into arrhythmia group and non-arrhythmia group. The values of QTd and Tp-Te value on the seventh day after PCI were analyzed. Results:The QTd and Tp-Te of AMI group were significantly longer than these of normal(P< 0.01). The QTd and Tp-Te of patients with AMI were significantly reduced after four hours of PCI(P< 0.01). The QTd and Tp-Te of arrhythmia group increased comparing with these of non-arrhythmia group(P< 0.01). Conclusion:The QTd and Tp-Te of patients with AMI are significantly reduced by PCI. PCI can reduce cardiac repolarization,improve cardiac electrical stability and significantly improve the prognosis of patients with AMI. QTd and Tp-Te can be used as a sensitive indicator to predict malignant arrhythmia on patients with AMI after PCI.更多还原