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目的 研究急性心肌梗塞 (AMI)后QT离散度 (QTd)的演变及其对快速室性心律失常的预测价值。方法 测量 34例AMI后患者不同时期和伴室性心律失常时的QTd ,并与健康对照组 (90名 )相比。结果 AMI后患者的QTd在急性期 (72± 18ms)明显大于亚急性期 (5 8± 17ms,P <0 .0 1) ,亚急性期大于陈旧期 (49± 2 1ms,P <0 .0 1) ,均明显大于对照组 (36± 10ms,P <0 .0 1)。陈旧期内心功能Ⅰ级、Ⅱ级者的QTd(36± 14ms,41± 15ms)与对照组无明显差异 (P >0 .0 5 ) ,Ⅲ～Ⅳ级者的QTd(6 6± 2 0ms)明显延长 (P <0 .0 1)。 9例AMI伴室速 /室颤 (VT/VF)者的QTd(91± 18ms)显著长于急性期不伴VT/VF者 (70± 14ms,P <0 .0 1)。结论 AMI后 0～ 3天QTd显著延长 ,随梗塞愈合渐趋正常 ,QTd显著延长是预示危重室性心律失常的不良之兆
Objective To study the evolution of QTd after acute myocardial infarction (AMI) and its predictive value for rapid ventricular arrhythmia. Methods QTd was measured in 34 patients with AMI at different stages and with ventricular arrhythmias and compared with healthy controls (n = 90). Results The QTd of patients after AMI was significantly higher than that of subacute (52 ± 17 ms, P <0.01) in the acute phase (72 ± 18 ms) and 49 ± 21 ms (49 ± 21 ms, P <0. 0) 1) were significantly higher than the control group (36 ± 10ms, P <0.01). QTd (36 ± 14ms, 41 ± 15ms) in patients with grade I and II in the elderly patients had no significant difference (P> 0.05) between QTd (6 6 ± 2 ms) Significantly longer (P <0.01). QTd (91 ± 18ms) in 9 patients with AMI with VT / VF was significantly longer than those without VT / VF in the acute phase (70 ± 14ms, P <0.01). Conclusion QTd was significantly prolonged from 0 to 3 days after AMI, with the normalization of infarction, significant QTd prolongation was a sign of adverse ventricular arrhythmias