摘要
目的：探讨急性心肌梗塞（ＡＭＩ）患者体表心电图ＱＴ离散度的演变规律及影响因素。方法：使用５０ｍｍ／ｓ纸速１２导同步心电图机对３７例患者发病１周内４次（入院即刻、发病２、４、７ｄ）ＱＴ离散度及相关指标进行动态观察，并与５０例正常对照进行对比分析。结果：ＡＭＩ早期ＱＴ离散度等指标较正常对照明显增大，且存在动态演变：入院２ｄ达最大值，４ｄ减小，７ｄ更小但仍高于正常。梗塞相关冠脉再通可明显减小ＱＴ离散度等指标：这种作用在下壁ＡＭＩ患者表现为抑制ＱＴ离散度等指标在发病２ｄ的增加；在前壁ＡＭＩ则表现为加快ＱＴ离散度等指标在４ｄ后的恢复。ＡＭＩ部位本身对ＱＴ离散度等指标的演变也有影响。与下后壁ＡＭＩ相比，前壁ＡＭＩ者的ＱＴ离散度增大较明显，恢复较慢。结论：ＡＭＩ急性期ＱＴ离散度等指标存在动态演变，梗塞相关冠脉再通可以改善ＱＴ离散度。
Objective:To evaluate the dynamic change of QT dispersion at the early stage
of acute myocardial infarction(AMI) and its response to thrombolytic
therapy.Methods:Synchrony 12 lead electrocardiogram was recorded with 50 mm/s paper
speed in 37 patients with AMI at admittion,in the second day,in the forth day and in
the seventh day after the occurrence of AMI and in 50 healthy controls.QT
dispersion(QTd),heart rate corrected QT dispersion(QTcd) and QT adjusted
dispersion(QTad) were used for analysis.Results:Patients with AMI had significant larger
QTd,QTcd and QTad than the controls.All the QTd parameters had the same pattern of
dynamic change rising to maximum in the second day after AMI,and falling after the
forth day.Patients with successful reperfusion had significant smaller QTd,QTcd and QTad
than those without reperfusion.In patients with anterior AMI,successful reperfusion
promoted the falling of QTd after the forth day of AMI,whereas in those with inferior
AMI,successful reperfusion seemed to prevent the rising of QTd in the second
day.Patients with inferior AMI or with left circumflex or right coronary artery occlusion
had smaller QTd in the forth and the seventh day after AMI than those with anterior
AMI or left anterior descending coronary artery occlusion.Conclusion:QTd with other two
parameters have dynamic change in the early stage of AMI.Successful reperfusion is
associated with little change of QTd in AMI patients.
出处
《中日友好医院学报》
1999年第1期41-44,共4页
Journal of China-Japan Friendship Hospital
关键词
心肌梗塞
血栓溶解疗法
QT离散
electrocardiography
myocardial infarction
thrombolytic therapy
reperfusion,regional
