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《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:

1997年第2期

页码:

85-87

栏目:

论著

出版日期:

1997-03-01

文章信息/Info

Title:

Relation between increased QT dispersion of acute myocardial infarction and regional wall motion abnormality

作者:

郑卫星　宋青杨　侯建萍　盖晓波

南京军区福州总医院心内科　福州 350025

Author(s):

Zheng Weixing ;  Song Qingyang ;  Hou Jianping ;  Gai Xiaobo

Department of Cardiovascular Disease, Fuzhou General Hospital of Nanjing Command,Fuzhou 350025

关键词:

心肌梗塞;  急性　QT间期离散度　室壁运动异常

Keywords:

myocardial infarction;  acute　QT dispersion　regional wall motion abnormality

分类号:

-

DOI:

-

文献标识码:

-

摘要:

观察28例急性心肌梗塞(AMI) 患者和30例稳定性劳力型心绞痛患者室壁运动异常(RWMA)的范围和程度与Q T离散度(QTd) 变化的关系。结果: ①AMI组早期即存在明显的RWMA,其RWMA的程度记分明显高于劳力型心绞痛患者。AMI后1周、4周的QTd值较对照组显著延长。②QTd 值随RWMA程度加重而逐渐延长, 前侧壁AMI的RWMA范围比下后壁AMI显著为大, 相应QTd亦显著延长。AMI后1周、4周QTd值与RWMA的范围和程度记分乘积呈显著正相关(r=0.78, r=0.71, P 均<0.01)。③溶栓再通组发病后1周、4周的QTd值较非溶栓组明显减少, 前者RWMA程度记分及范围亦较后者显著减少。结论:AMI后QTd显著延长, 并与RWMA程度加重及范围扩大呈密切相关。

Abstract:

In order to explore the relation between increased QT dispersion (QTd) and left ventricular regional wall motion abnormality (RWMA) in acute myocardial infarction(AMI),the QTd and the extent and degree of RWMA in 28 patients of early AMI and in 30 cases of effort angina (control group) were measured. The results: 1. In AMI group there was serious RWMA ,while in control group the severity of RWMA was mild and the calculated fraction of RWMA degree was lower than that in AMI group. The QTd in AMI group was longer than that in the control group. 2. The extent of RWMA in anterolateral wall AMI group was more significantly enlarged than that in inferoposterior wall AMI, the QTd was also longer in anterolateral wall AMI than in inferoposterior wall AMI. The QTd was significantly correlated with the product of the extent and degree of RWMA (P<0.01). 3.The QTd of the patients with successful reperfusion by thrombolytic therapy was more significantly decreased than that of the patients by non-thrombolytic therapy (P<0.05) ,while the extent and degree of RWMA in the lower QTd patients were more significantly reduced than in the higher QTd patients. The results showed that the QTd in early AMI was higher than in effort angina and the QTd change was close correlated with the extent and degree of RWMA. The thrombolytic therapy could reduce the QTd and the extent and degree of RWMA in the patients of early AMI.

参考文献/References

［1］Pfeffer MA ,Braumwald E. Ventricular remodeling after myocardial infarction: Experimental observations and clinical implications. Circulation,1990; 81 (4) : 1161.

［2］ White HD, Norris RM , Brown MA , et al. Left ventricular end-systolic volume as the major determinant of survival after recovery from myocardial infarctions. Circulation, 1987; 76 (1) : 44.

［3］ Higham PD, Funiss SS. Increased QT dispersion in patients with ventricular fibrillation following myocardial infarction. Circulation, 1991; 84(Suppl Ⅱ ) : 61.

［4］ 中华心血管病杂志编委会.急性心肌梗塞溶栓疗法参考方案中华心血管病杂志, 1991; 19:137.

［5］ Barr CS, Freeman AN , Lang CC, et al. QT dispersion and sudden unexpected death in ch ronic heart failure. Lancet, 1994; 343: 327.

［6］Moreno FL ,Villanueva MT, Karagounis KA , et al. Reduction in QT interval dispersion by successful thromobolytic therapy in acute myocardial infarction. Circulation, 1994; 90: 94.

备注/Memo

备注/Memo:

Received 1996-12-13；revised 1997-04-08

常用功能

更新日期/Last Update: 1997-03-01