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溶栓治疗后的QT离散度

QT Dispersion after Thrombolytic Therapy.

作者信息

Oni Heris Saeed, Rahimi Behzad, Faridaalaee Gholamreza, Hajahmadi Mojgan, Sayyadi Hojjat, Naghipour Bahman

机构信息

Shahid Rajaee Heart Center, Tehran, IR Iran.

Cardiology Department, Urmia University of Medical Sciences, Urmia, IR Iran.

出版信息

Int Cardiovasc Res J. 2014 Dec;8(4):161-5. Epub 2014 Dec 1.

Abstract

BACKGROUND

QT dispersion (QTd) is equal to longer QTc minus shorter QTc measured by 12-lead electrocardiogram (ECG). QTd reflects inhomogeneity in repolarization of ventricular myocardium and because of easy and fast measurement of QTd, it can be used to predict high-risk patients for dysrhythmia after Acute Myocardial Infarction (AMI).

OBJECTIVES

This study aimed to assess the effect of thrombolytic therapy on QTd before and 1 hour and 4 days after beginning of thrombolytic therapy.

PATIENTS AND METHODS

The patients with chest pain and ST Elevated Myocardial Infarction (STEMI) that underwent thrombolytic therapy were enrolled into this study. Streptokinase was the thrombolytic agent in all the patients. Standard 12-lead (ECG) was evaluated before beginning of thrombolytic therapy (QTd 1) and 1 hour (QTd2) and 4 days (QTd3) after thrombolytic therapy. First, ECG was magnified × 10 for exact calculation of QT and QTd. After all, the variables were compared using one-way analysis of variance (ANOVA). Besides, P ≤ 0.05 was considered as statistically significant.

RESULTS

This study was conducted on 160 patients. The results revealed no significant differences among QTd 1, QTd 2, and QTd 3 (P > 0.05). At inferior AMI, however, a significant difference was observed among QTd1, QTd2, and QTd3 (P = 0.031).

CONCLUSIONS

Thrombolytic therapy had no significant effects on QTd. Thus, thrombolytic therapy does not increase the risk of arrhythmia.

摘要

背景

QT离散度(QTd)等于12导联心电图(ECG)测量的最长QTc减去最短QTc。QTd反映心室肌复极的不均一性,由于QTd测量简便快捷,可用于预测急性心肌梗死(AMI)后心律失常的高危患者。

目的

本研究旨在评估溶栓治疗开始前、溶栓治疗开始后1小时和4天QTd的变化。

患者与方法

纳入接受溶栓治疗的胸痛及ST段抬高型心肌梗死(STEMI)患者。所有患者均使用链激酶作为溶栓剂。在溶栓治疗开始前(QTd 1)、溶栓治疗后1小时(QTd2)和4天(QTd3)评估标准12导联(ECG)。首先,将ECG放大10倍以精确计算QT和QTd。最后,采用单因素方差分析(ANOVA)比较变量。此外,P≤0.05被认为具有统计学意义。

结果

本研究共纳入160例患者。结果显示QTd 1、QTd 2和QTd 3之间无显著差异(P>0.05)。然而,在下壁AMI中,QTd1、QTd2和QTd3之间观察到显著差异(P = 0.031)。

结论

溶栓治疗对QTd无显著影响。因此,溶栓治疗不会增加心律失常的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e337/4302504/419691706b94/icrj-08-161-i001.jpg

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