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[提要]心律失常是急性心肌梗死(AMI)患者发病后早期常见的并发症,而AMI患者发生心律失常的预测因子一直是临床医师关注的热点。近些年发现心肌缺血可显著影响心肌细胞的离子通道,造成缺血心肌复极离散度(TDR)的增大,并且缺血引起的自主神经紊乱进一步增大了TDR,并触发2相折返,引发室性心律失常。与QT、QTd相比,Tpe在恶性心律失常上具有更好的预测价值,深入了解Tpe与心律失常关系及作用机制,对有效防治心律失常有重要的临床意义。
[Abstract] Arrhythmia is a common early complication after AMI. However, the predictor of arrhythmia in AMI patients has always been a hot issue for clinicians. In recent years, it has been found that myocardial ischemia can significantly affect the ion channels of myocardial cells, resulting in an increase of ischemic myocardial repolarization dispersion (TDR), and autonomic dysfunction caused by ischemia further increases TDR and triggers 2-phase reentry , Triggering ventricular arrhythmia. Compared with QT and QTd, Tpe has a better predictive value in malignant arrhythmia. It is of great clinical significance to understand the relationship between Tpe and arrhythmia and its mechanism of action.