【摘要】 目的 探讨急性心肌梗死静脉溶栓疗效对QTd的影响，QTd的变化与恶性室性心律失常的相关性。方法 将128例急性心肌梗死静脉溶栓的病人分成再通组和未再通组，比较静脉溶栓前、后2小时、12小时、24小时、2~7天、14天、21天和睦周的QTd、QTcd的变化，同时比较两组恶性室性心律失常的发生情况。结果 静脉溶栓再通组QTd、QTcd呈逐渐减小，恶性室性心律失常的发生率明显降低；静脉溶栓未再通组QTd、QTcd变化不大，恶性心律失常的发生率明显增高。结论 1)急性心肌梗死静脉溶栓再通可降低QTd、QTcd，同时降低室性心律失常的发生。两组比较有极显著性差异。(P<0.001)2)QTd、QTcd与室性心律失常的发生具有明显的相关性。

    【关键词】 急性心肌梗死 静脉溶栓 QT离散度

    QTd’s Changes of AMI before and after of Intravenous Thrombolysis and Affect Analysis of Risking Ventricular Arrhythmia

    Tong Yidong,et al.

    (Department of Cardiology,Bei Gang Hospital,Qiqihar,Hilongjiang 161041,China)

    【Abstract】 Objective To assess the effect of acute myocardial infarction of intravenous thrombolysis with QTd’s affect,relationship of QTd’s changes and risk’ ventricular arrhythmia.Methods One hundred and twenty-eight patients were divided into intravenous thrombolysis recanalization、non-intravenous thrombolysis recanalization,comparing with QTd、QTcd changing before intravenous thrombolysis and after 2-hour、12-hour、24-hour、2-7day、14-day、21-day、4weeks,comparing two groups’ risking ventricular arrhythmia at the same time.Results The QTd、QTcd of Intravenous thrombolysis recanalization group was reduced,the positive rate of risk of ventricular arrhythmia was significantly lower.The QTd、QTcd changes of non-intravenous thrombolysis recanalization was not significant,the positive rate of risking of ventricular arrhythmia was significantly higher.Two Comparing groups were significantly different (P<0.001).Conclusions 1)Acute myocardial infarction intravenous thrombolysis recanalization can reduce QTd、QTcd and the positive rate of ventricular arrhythmia.2)The relationship is significant between QTd、QTcd and risk of ventricular arrhythmia. ......