运动负荷对缺血心肌QT间期离散度的影响

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目的:探讨运动对缺血性心脏病(IHD)QT离散度的影响及β受体阻滞剂的干预作用。方法:观察27例IHD(IHD组),24例接受β受体阻滞剂治疗的IHD(IHD-β组)和14例正常人(正常组)静息和平板运动高峰时QT间期及其相关参数。结果:静息和运动高峰时IHD和IHD-β组QT间期较正常组显著延长,但心率校正后差异无显著性。IHD与正常组比较,静息时QTd,QTcd,运动高峰时QTd,QTcd均显著增加。IHD-β组与IHD组比较,静息时QTd,QTcd显著延长,但运动高峰时差异无显著性。而IHD-β组和正常组比较,仅运动时QTd,QTcd显著增加,静息时QTd,QTcd差异无显著性。QTd,QTcd变化率IHD组显著高于IHD-β组和正常组。结论:IHD患者运动高峰时QTd及其QTd,QTcd变化率增加,β受体阻滞剂降低运动诱发的QTd,QTcd升高,缩小运动高峰时心肌缺血复极的离散程度。 Objective: To investigate the effect of exercise on QT dispersion in ischemic heart disease (IHD) and the effect of β-blocker. Methods: The QT interval and the QT interval at resting and platelet movement in 27 patients with IHD (IHD group), 24 patients with IHD (β-blocker) and 14 normal subjects (normal group) Related parameters. Results: The QT interval of IHD and IHD-β group at resting and exercise peak was significantly longer than that of the normal group, but there was no significant difference after correction of heart rate. IHD compared with the normal group, resting QTd, QTcd, peak exercise QTd, QTcd were significantly increased. IHD-β group compared with IHD group, resting QTd, QTcd significantly prolonged, but the difference was not significant at the peak of exercise. However, compared with the normal group, the QTd and QTcd of the IHD-β group were significantly increased only during exercise, and there was no significant difference between the QTd and QTcd groups at rest. QTd, QTcd rate of change IHD group was significantly higher than the IHD-β group and the normal group. Conclusion: The QTd, QTd and QTcd changes of patients with IHD at peak exercise time are increased. Beta blockers reduce QTd and QTcd induced by exercise, and reduce the dispersion of repolarization of myocardial ischemia at peak exercise time.
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