QT间期离散度与急性心肌梗死患者预后的关系

通过观察急性心肌梗死(AMI)患者QT间期离散度(QTd)变化,探讨其与临床关系。应用体表同步十二导联心电图对168例AMI患者进行心电图QTd和校正QT间期离散度(QTcd)测定,并与168例正常人做对照。结果表明:AMI患者入院后心电图的QTd、QTcd均明显长于对照组(P<0.01);室性心律失常组、心衰组、死亡组QTd、QTcd均明显长于非心律失常组、非心衰组、生存组(P<0.01);前壁组QTd、QTcd明显长于下后壁组(P<0.01);AMI组中QTmax存在于梗死或缺血区导联163例,占97%。AMI中发生室性心律失常组QTd增加均>60 ms,其中6例室颤QTd均>100 ms。综上得出结论:AMI患者QTd、QTcd明显延长,为AMI发生室性心律失常、心力衰竭和猝死简单而实用的重要预测指标。QTd>60 ms可以作为预测心肌梗死患者发生室性心律失常的指标,而QTd>100 ms是识别高危心律失常的敏感指标。

Relationship between QT Dispersion and Prognosis of Patients with Acute Myocardial Infarction

To investigate the relationship between QT dispersion（QTd） and clinical features in patients with acute myocardial infarction（AMI）,the QTd and QT corrected dispersion（QTcd） on of 168 patients with AMI were tested with the 12-lead synchrony ECG.They were also compared with those of 168 normal persons.The results showed that the patients＇ QTd and QTcd on ECG were significantly longer than those in the control group（P0.01）.The QTd and QTcd of patients in death group,ventricular arrhythmia group and heart failure group were significantly longer than those in the survival group,non-arrythmia group and non-heart-failure group（P0.01）.The QTd and QTcd of patients in anterior wall group were significantly longer than those of the under and posterior wall group（P 0.01）.QTmax of AMI group existed in 163 infarction or ischemia lead,accounting for 97%.The QTd and QTcd increase were greater than 60 ms when patients with AMI occurred in the ventricular arrhythmia.The QTd and QTcd in 6 ventricular fibrillation patients were greater than 100 ms.It is concluded that the obviously prolonged QTd and QTcd in patients with AMI can be a simple,practical and important index for forecasting heart accidents and sudden death in AMI.QTd greater than 60 ms can be used as an indicator to predict myocardial infarction patients with ventricular arrhythmias.QTd greater than 100 ms is a sensitive indicator to identify high-risk arrhythmia.