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目的:观察急性心肌梗塞(AMI)溶栓再通后QT离散度的动态变化趋势。方法:按临床判通标准将符合入选条件的32例AMI患者分为再通与未通两组,测量溶栓前及溶栓后3h内每30min复查1决心电图的QTd数据。结果:再通组溶栓后1.5hQT略有增大,但与溶栓前比较,差异无显著性P>0.05;2h,2.5h,3h QTd明显降低,与溶栓前比较差异非常显著P<0.01。呈现1.5h QTd增大,2h后QTd快速下降的动态变化趋势。结论:梗塞部位再灌注后,改善了缺血部位与正常心肌之间局部心室复极电活动的差异,溶栓后2hQTd因干扰因素较少,对判定AMI溶栓疗效有一定的价值。
Objective: To observe the dynamic change trend of QT dispersion after acute myocardial infarction (AMI) recanalization. Methods: Thirty-two cases of AMI who met the inclusion criteria were divided into two groups: recanalization and failure according to clinical criteria. The QTd data of ECG before and after thrombolysis were measured every 30 minutes before and after thrombolysis. Results: The QT increased slightly 1.5h after thrombolysis in reperfusion group, but there was no significant difference between before and after thrombolysis (P> 0.05); QTd at 2h, 2.5h and 3h was significantly lower than that before thrombolysis (P < 0.01. Showing 1.5h QTd increased, 2h QTd rapid decline in the dynamic trend. CONCLUSION: After reperfusion of infarction site, the difference of local ventricular repolarization activity between ischemic site and normal myocardium is improved. There are few interference factors of QTd at 2h after thrombolysis, which is of certain value in judging the efficacy of AMI thrombolysis.