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目的 :探讨急性心肌梗塞 (AMI)患者福辛普利 (fosinopril)干预前后校正 QT间期离散度 (QTcd)的变化。 方法 :46例 AMI患者分基础治疗 +福辛普利 10 mg/ d治疗组 (A组 ,2 3例 )和基础治疗组 (B组 ,2 3例 ) ,并对治疗前和治疗 7天后的 QTcd进行对比分析。另设正常人组 2 0例 (C组 )作对照。 结果 :A组、B组患者 QTcd较 C组明显增加 (P<0 .0 1) ,在 46例 AMI患者中伴室性心律失常者 (n=30 )高于无室性心律失常者 (n=16 ,P<0 .0 1) ,前壁心肌梗塞 (n=31)与下后壁心肌梗塞 (n=15 )间 QTcd差异无显著性 (P>0 .0 5 )。治疗 7天后 A、B两组的 QTcd均较治疗前明显降低 (P均 <0 .0 1) ,但 A组较 B组下降更为显著 ,两组间有显著性差异 (P<0 .0 1)。 结论 :AMI患者早期 QTcd增加 ,并且与室性心律失常的发生有关 ,福辛普利可降低 AMI早期 QTcd。本结果对改善 AMI近期预后有重要意义。
Objective: To investigate the changes of QTcd (QTcd) before and after fosinopril intervention in patients with acute myocardial infarction (AMI). Methods: Forty-six patients with AMI were divided into two groups according to basic treatment plus fosinopril 10 mg / d (group A, n = 23) and basic treatment group (group B, n = 23) QTcd comparative analysis. Another normal group 20 cases (C group) as a control. Results: The QTcd in group A and group B was significantly higher than that in group C (P <0.01). In 46 patients with AMI, those with ventricular arrhythmia (n = 30) were higher than those without ventricular arrhythmia = 16, P <0.01). There was no significant difference in QTcd between anterior myocardial infarction (n = 31) and inferior posterior myocardial infarction (n = 15) (P> 0.05). After 7 days of treatment, the QTcd in A and B groups were significantly lower than those before treatment (P <0.01), but the decrease in group A was more significant than that in group B, with significant difference between the two groups (P <0. 0 1). CONCLUSIONS: QTcd increases in early AMI patients and is associated with the occurrence of ventricular arrhythmias. Fosinopril can reduce QTcd in early AMI. This result is of great importance to improve the short-term prognosis of AMI.