经皮腔内冠状动脉介入术后心室肌复极心电学研究  

An Electrocardiological Observation on Repolarization and Improvement of Ventricular Muscle after the Operation of Percutaneous Coronary Intervention

作　　者：李宗庄[1] 张陈匀[1] 蔡运昌[1] 杨天和[1] 刘志琴[1] 刘晓桥[1] 郑亚西[1] 吴强[1] 韦方[1] 

机构地区：[1]贵州省人民医院心内科,贵州贵阳550002

出　　处：《贵阳医学院学报》2007年第6期608-610,共3页Journal of Guiyang Medical College

摘　　要：目的:观察经皮腔内冠状动脉介入治疗(PCI)血运重建术对心肌复极指标——QT离散度及T波振幅的影响。方法:38例冠心病患者,冠状动脉造影显示一支或多支冠状动脉狭窄≥75%并行PCI术,于术前,术后1天、3天、1周、1个月同步记录十二导联体表心电图。测量并计算各项心室肌复极心电学指标:QTd、QTcd、总T波振幅(ΣT)、总正向T波振幅(ΣT+)、总负向T波振幅(ΣT-)。结果:术后各时间点QTd、QTcd较术前明显降低(P<0.001),术后各时间点之间比较无统计学差异;ΣT、ΣT+在1个月明显增大,与术前及术后各时间点有显著差异(P<0.001),ΣT+术后1d较术前明显降低(P<0.05),ΣT-术后1个月负值减小,与术前至术后1周比较有统计学意义(P<0.005;P<0.001)。结论:PCI后QT离散度与T波振幅、极向呈非同步性改善,可作为PCI后不同时期的心室肌复极改善的指标。Objective： To investigate the effect of percutaneous coronary intervention （PCI） on ventricular repolarization which was indicated as QT dispersion and amplitude of T-wave in patients with operated heart disease. Methods： Thirty-eight patients with coronary heart disease were chosen to be on with PCI based on that stenosis lesions was 75 percent or above. Among them, 13 suffered myocardial tients and 1 infarction, 24 had unstable angina pectoris, and 1 had stable angina pectoris. All the pawere examined with coronary angiocardiography before the operation and 1 day, 3 days, 7 days month after PCI,and synchronous 12 lead electrocardiography was recorded. The ventricular repolarizartion indexes including QT dispersion （QTd）, corrected QT dispersion （QTcd）, sigma amplitude of all T-wave, positive T-wave and negative T-wave were measured and calculated. Results： QTd and QTcd decreased from the first day to one month after PCI （P 〈 0.001 ）. The sigrna amplitudes of all T-wave and positive T-wave increased and that of negative T-wave decreased significantly in one month after PCI in comparison with those before and after PCI at different time points （ P 〈 0.005 or P 〈0.001 ）, while that of positive T-wave decreased significantly on the first day after PCI （P 〈0.05） in comparison with that before. Conclusions： QTd and T-wave amplitude improved non-synchronously after coronary revascularization which may be very useful for indicating of ventricular repolarization and improvement after PCI.

关 键 词：心电描记术 血管成形术 经腔 经皮冠状动脉 心室 

分 类 号：R541.41[医药卫生—心血管疾病] R541.4[医药卫生—内科学]