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目的:探讨急性ST段抬高型心肌梗死(STEMI)患者的症状发作至球囊扩张时间(SOTBT)对QT离散度(QTd)的影响。方法:收集82例急性STEMI行直接PCI治疗患者,根据SOTBT分为<3h组、3~6h组、>6h组,测量各组PCI术前、术后24h、术后72h心电图QTd及心率校正QT间期离散度(QTcd),比较各组间QTd及QTcd的变化差异。结果:PCI术前,SOTBT<3h组的QTd及QTcd较SOTBT 3~6h组和SOTBT>6h组明显延长(P<0.05或P<0.01);3组PCI术后24h及72h的QTd、QTcd均较术前显著缩短(P<0.05或P<0.01);术后24h,随着SOTBT的延长,QTd及QTcd缩短值逐渐下降,SOTBT<3h组的变化最大,QTd缩短值为(32.5±11.2)ms,QTd平均缩短率为43.6%,QTcd缩短值为(35.5±11.8)ms,QTcd平均缩短率为44.6%,分别与其他2组相比均差异有统计学意义(P<0.01);术后72hQTd及QTcd在术后24h的基础上有进一步下降,但变化在各组并不显著。结论:直接PCI治疗能显著缩短急性STEMI患者的QTd,与SOTBT 3~6h组和>6h组相比,SOTBT<3h组QTd缩短更显著,且在PCI术后的最初24h缩短幅度最大,表明急诊PCI患者SOTBT越短,疗效更佳。
Objective: To investigate the effect of SOTBT on QTd in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: Eighty-two patients undergoing direct PCI with acute STEMI were enrolled. According to SOTBT, patients were divided into 3h, 3h, 6h, and 6h groups. The QTd and QT Interphase dispersion (QTcd) was used to compare the QTd and QTcd differences between groups. Results: Before PCI, the QTd and QTcd in SOTBT <3h group were significantly longer than those in SOTBT 3 ~ 6h and SOTBT> 6h group (P <0.05 or P <0.01); QTd and QTcd in 24h and 72h The shortening of QTd and QTcd decreased gradually with the extension of SOTBT at 24 hours after operation, and the change of QTd shortened to (32.5 ± 11.2) days in SOTBT <3h group was significantly shorter than that before operation (P <0.05 or P <0.01) The average shortening rate of QTd was 43.6%, the shortening of QTcd was (35.5 ± 11.8) ms and the average shortening rate of QTcd was 44.6%, which was significantly different from the other two groups (P <0.01) 72hQTd and QTcd on the basis of 24h after further decline, but the changes in each group is not significant. Conclusions: QTd in acute STEMI patients can be significantly shortened by direct PCI. Compared with SOTBT 3 ~ 6h group and> 6h group, QTd shortened more significantly in SOTBT <3h group and shortened the most in the first 24 hours after PCI, indicating that emergency treatment SITBT PCI patients shorter, better effect.