我们的网站为什么显示成这样？

可能因为您的浏览器不支持样式，您可以更新您的浏览器到最新版本，以获取对此功能的支持，访问下面的网站，获取关于浏览器的信息：

|本期目录/Table of Contents|

急性心肌梗死后梗死相关动脉再灌注对QT离散度的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2005年第1期
页码:
68-70
栏目:
临床研究
出版日期:
2005-01-05

文章信息/Info

Title:
Effects of reperfusion of infarct-related artery after intravenous thrombmolysis in AMI on QTc dispersion
作者:
李迪俊1; 邱汉婴2; 吴波1
汕头大学医学院：1.附一院心电图室，2.附二院心内科，广东 汕头 515041
Author(s):
LI Dijun1;  QIU Hanying2; WU Bo1
1. Cardiovascular Division, First Affiliated Hospital; 2. Department of Cardiology, Second Affiliated Hospital, Shantou University Medical College, Shantou,Guangdong 515041,China
关键词:
心肌梗塞; 急性; 溶栓;  冠状动脉内支架置入术; QT间期离散度
Keywords:
myocardial infarction;  acute;  thrombolytic; coronary stenting ;  QT interval dispersion
分类号:
R542.22
DOI:
-
文献标识码:
A
摘要:
目的 了解急性心肌梗死（AMI）患者梗死相关动脉（IRA）,早期静脉溶栓再灌注或冠状动脉内支架置入术对QT离散度（QTd）的影响。方法 对AMI 47例予以静脉内溶栓，于溶栓后90 min进行选择性冠状动脉造影，对判定为心肌梗死溶栓治疗试验（TIMI）II级以下者，其中13例进行冠状动脉内支架置入术。在溶栓前后作同步12导联心电图测量分析QTd，并与38例冠状动脉造影正常者进行对照。结果 AMI组溶栓前与对照组间QTd有极显著差异(83±12 ms vs 60±12 ms，P<0.01)；前壁与下壁梗死之间QTd差异无显著性。静脉溶栓后90 min冠状动脉造影显示IRA血流达到TIMI II～III者，溶栓后2 h QTd显著降低(70±13 ms)，而IRA未开通者，其QTd在溶栓前后始终保持较高水平。IRA开通患者与冠状动脉内支架置入术患者之间的QTd差异无显著性。１５例溶栓前有恶性心律失常者，其QTd明显高于无伴心律失常者（93±12 ms vs 82±12 ms，P<0.05），溶栓后或冠状动脉内支架置入术后其IRA血流均达TIMI III级，室性心律失常消失。结论 成功地使IRA再灌注可使QTd显著降低，IRA早期再灌注，可减少恶性心律失常的发生。
Abstract:
AIM To evaluate the effect of early reperfusion of infarctrelated artery (IRA) after intravenous thrombolysis on QT dispersion (QTd) . METHODS 47 acute myocardial infarction (AMI) patients and 38 nomal coronary artery subjects used as control were studied. Coronary artery angiograpy was done at 90th minute after intravenous thrombolysis therapy in AMI patients. IRA under TIMI II flow of 13 patients had been implanted coronary stents, and QTd was measured before and after thrombolysis. RESULTS QTd was significantly prolonged in patients with AMI before thrombolysis compared with control group(83±12 ms vs 60±12 ms，P<0.01). There was no significant difference in QTd between anterior AMI and inferior AMI . At 2nd hour after intravenous thrombolysis QTd decreased significantly in TIMI II~III grade group ( 70±13 ms), and QTd remained unchanged in under TIMI II grade group.There was no significantly difference in QTd between in TIMI II~III grade group with implanted coronary stents. 15 AMI patients were associated with malignant ventricular arrhythmias before thrombolysis and the QTd was significantly longer in these patients as compared with those patients without arrhythmias（93±12 ms vs 82±12 ms，P<0.05）. After thrombolysis, all of the 15 patients achieved TIMI III grade flow of IRA, and were associated with a significant reduction of QTd and disappearance of ventricular arrhythmias. CONCLUSION Successful early reperfusion of IRA is associated with the reduction of QTd and the decreased risk of ventricular arrhythmias in AMI patients.

参考文献/References

［1］ 毕爱华，刘加麟，胡建荣，等. QT间期离散度的电生理基础及临床意义［J］ .心脏杂志，2003，15（3）：276-276.

［2］ Yunus A, Wamica W, Mitchell LB. Precordial QTc interval dispersion as predictor of ventricular fibrillation in acute myocardial infarction［J］. PACE, 1994, 17:752-755.

［3］ 中华医学会心血管病学分会. 急性心肌梗死诊断和治疗指南［J］. 中华心血管病杂志, 2001,29: 710-725.

［4］Davey PP, Batman J, Malligan ID, et al. QT interval dispersion in chronic heart failure and left ventricular hypertrophy: relation to autonomic nerves system and Holter tape abnormalities［J］. Br Heart J， 1994, 71(3): 268.

［5］ Moreno FL, Villanueva T, Karagounis LA, et al. Reduction in QT interval dispersion by successful thrombolytic therapy in acute myocardial infarction, TEAM2 study investigators［J］. Circulation, 1994,90: 94-97.

备注/Memo

备注/Memo:
收稿日期：2004-03-20.
更新日期/Last Update: 2010-01-05