不稳定性心绞痛患者介入治疗前后T波峰末间期、QT离散度的变化及意义

摘要

目的 探讨经皮冠状动脉介入治疗(PCI)对不稳定性心绞痛(UA)患者T波峰末间期(Tpeak-Tend interval,Tp-Te间期)和QT离散度(QTd)的影响及其与室性心律失常(VA)的关系.方法 纳入UA患者62例,分别于入院时、PCI术后第1天及术后第7天测算其12导联体表心电图最长Tp-Te间期、QTd值,记录入院24 h及PCI术后第7天VA的发生情况.所有患者采用手术前后自身对照,比较所有患者手术前后Tp-Te、QTd及VA发生率等指标;根据冠脉造影结果,把UA患者进一步分为三组:单支血管病变组、双支病变组和三支病变组,对三组患者PCI术前后Tp-Te、QTd及VA发生率等指标进行分析比较.结果 与单支血管病变组相比,双支病变组和三支病变组Tp-Te间期、QTd值均增大(P < 0.05);与PCI术前相比,单支血管病变组及双支病变组PCI术后24 h和第7天Tp-Te间期、QTd值均减小(均P ＜ 0.05),三支血管病变组术后第7天Tp-Te间期、QTd值也均减小(均P < 0.05),但PCI术后24 h Tp-Te间期、QTd值变化不明显(P > 0.05).与入院24 h相比,PCI术后第7天VA的发生率(20.97% vs 8.06%)降低(P ＜ 0.05).结论 PCI术可降低UA患者的Tp-Te间期、QTd值,从而降低UA患者VA的发生率.%Objective To investigate the influence of percutaneous coronary intervention (PCI) on the Tpeak-Tend interval (Tp-Te interval) and the QT dispersion (QTd) of patients with unstable angina (UA) and its relationship with ventricular arrhythmia (VA). Methods Sixty-two patients with UA were included in this study. The longest Tp-Te intervals and QTd values in 12-lead surface electrocardiogram at hospital admission, in post-PCI day 1 and in post-PCI day 7 were measured and calculated. The occurrence of VA within 24 hours of admission and in post-PCI day 7 was recorded. All the patients were sell control between before and after surgery. The Tp-Te, QTd, VA occurrence and other indicators of all the patients before and after the surgery were compared. According to the coronary angiography, patients with UA were further divided into three groups: single vessel lesion group, double vessel lesion group and triple vessel lesion group. The Tp-Te, QTd, VA occurrence and other indicators of the three groups of patients before and after PCI were compared. Results Compared with ihe single vessel lesion group, the Tp Te interval and QTd valise of the double vessel lesion group and the triple vessel lesion group increased (P ＜ 0.05). Compared with before the PCI, the Tp-Te intervals and QTd values of the single vessel lesion group and the double vessel lesion group within 24 hours after PCI and in post-PCI day 7 reduced fall P ＜ 0.05), the Tp-Te interval and QTd value of the triple vessel lesion group in post-PCI day 7 also reduced (all P ＜ 0.05), but the Tp-Te interval and QTd value of the triple vessel lesion group within 24 hours after PCI did not change significantly (P ＞ 0.05). Compared with within 24 hours of admission, the occurrence rate of VA in post-PCI day 7 reduced (20.97% vs 8.06%) (P ＞ 0.05). Conclusion PCI can reduce the Tp Te interval and QTd value of patients with UA, thereby reducing their occurrence rate.