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目的:探讨急性心肌梗死(AMI)患者静脉溶栓前后QT离散度(QTd)变化及其对预后的影响。方法:105例AMI患者分为溶栓再通组、未通组和未溶栓组。测定其溶栓前及溶栓治疗1、2周后QTd变化,并与未溶栓组比较。同时比较三组治疗2周时高危室性心律失常。结果:溶栓治疗再通治疗1、2周后QTd显著缩小(P皆<0.01),高危室性心律失常的发生率低.其与未通组和未溶栓组比较,差异皆有显著性(P<0.01)。而未通组、未溶栓组治疗前后QTd变化和高危室性心律失常的发生率皆无差异(P<0.05)。结论:AMI后2周内QTd增大者,其溶栓再通的可能性小,发生高危室性心律失常的可能性增大。
Objective: To investigate the changes of QTd before and after intravenous thrombolysis in patients with acute myocardial infarction (AMI) and its effect on prognosis. Methods: 105 patients with AMI were divided into thrombolytic group, failed group and no thrombolysis group. The changes of QTd before and 1, 2 weeks after thrombolytic therapy were measured and compared with those without thrombolysis. At the same time compared three groups of high-risk ventricular arrhythmias 2 weeks. Results: After 1 and 2 weeks of thrombolysis recanalization, the QTd was significantly reduced (all P <0.01), and the incidence of high-risk ventricular arrhythmias was low. There was significant difference between the untreated group and the untreated group (P <0.01). However, there was no difference in the QTd changes and the incidence of high risk ventricular arrhythmias between the untreated group and the untreated group (P <0.05). Conclusion: The increase of QTd within 2 weeks after AMI is less likely to be recanalized by thrombolytic therapy and the risk of developing high-risk ventricular arrhythmias increases.