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目的:观察急性心肌梗死患者溶栓治疗后QT离散度的动态变化,探讨其在判断溶栓再通中的临床价值。方法急性心肌梗死患者50例应用尿激酶150万单位进行溶栓治疗,在溶栓前、溶栓开始后0.5、1、1.5、2、3、4、5、6小时分别记录12导联同步心电图,计算各时段QTd,溶栓后根据再通情况分为再通组和非再通组进行组间比较。结果:溶栓后0.5、1、1.5小时再通组QTd呈上升趋势,之后QTd明显下降,至溶栓后6小时达低谷。未通组溶栓前后QT离散度变化趋势不明显。溶栓后0.5、1、1.5小时再通组QTd明显高于未通组,2小时~6小时再通组QTd明显低于未通组(P<0.01)。结论急性心肌梗死溶栓再通过程中QTd发生了动态性变化,QTd可作为观察溶栓和再灌注效果的一个有效指标。
Objective: To observe the dynamic changes of QT dispersion after thrombolysis in patients with acute myocardial infarction and to explore its clinical value in judging the thrombolytic recanalization. Methods Fifty patients with acute myocardial infarction were treated with 1.5 million units of urokinase for thrombolytic therapy. Before thrombolysis, the 12-lead synchronous electrocardiogram was recorded at 0.5, 1, 1.5, 2, 3, 4, , Calculate the time of QTd, according to recanalization after thrombolysis is divided into recanalization group and non-recanalization group for comparison between groups. Results: After 0.5, 1, 1.5 hours of thrombolytic therapy, the QTd of the recanalization group showed an upward trend, followed by a significant decrease of QTd, reaching a low level 6 hours after thrombolysis. QT dispersion before and after thrombolysis did not change significantly. QTd of recanalization group was significantly higher than that of non-recanalization group at 0.5,1,1.5 hours after thrombolysis, and QTd of recanalization group was significantly lower than that of non-recanalization group (P <0.01) after 2 hours to 6 hours. Conclusion The dynamic changes of QTd in acute myocardial infarction after thrombolysis and recanalization can be used as an effective indicator to observe the effect of thrombolysis and reperfusion.