抗焦虑治疗对急性心肌梗死患者急诊经皮冠状动脉介入术后QT离散度和心肌室壁运动变化的影响  

The effect of anti-anxiety treatment on QT dispersion and ventricular wall motion in the patients with acute myocardial infarction and emergency percutaneous coronary intervention

作　　者：吴莉娜[1] 韩立宪[1] 张红娟[1] 曹绪芬[1] 颜利求[1] 宣之东[2] 

机构地区：[1]河北沧州市中心医院心内一科,061000 [2]河北沧州市中心医院彩超室,061000

出　　处：《中国介入心脏病学杂志》2010年第1期25-27,共3页Chinese Journal of Interventional Cardiology

摘　　要：目的探讨抗焦虑治疗对急性心肌梗死(AMI)合并焦虑情绪患者急诊经皮冠状动脉介入术(PCI)后QT离散度(QTd)和心肌室壁运动变化(RWMA)的影响。方法将2005年1月至2007年5月在我科住院AMI合并焦虑情绪并行急诊PCI术的患者59例[约占同期AMI患者PCI术总量24.5%(59/240)],随机分为对照组(28例)和焦虑治疗组(31例)。对照组遵循PCI指南对患者进行常规治疗。焦虑治疗组在常规疗法的基础上,采用咪达唑仑联合焦虑系统脱敏的方法抗焦虑治疗。对比两组急诊PCI术后12～16h、72～78h、7d的QTd,以及治疗后7～10d的RWMA的差异。结果PCI术后对比焦虑治疗组与对照组QTd:12～16h(66±11ms比70±10ms,P<0.05)、72～78h(37±4ms比42±5ms,P<0.01)和7d时(31±4ms比36±3ms,P<0.05)治疗组均低于对照组;治疗后7～10d的RWMA对比:焦虑治疗组心肌室壁运动积分指数明显低于对照组(1.5±1.1比1.8±1.0,P<0.05),焦虑治疗组收缩期增厚率、室壁运动幅度明显高于对照组(30.1%±15.2%比25.1%±11.8%,5.0±2.3mm比4.8±2.1mm,P均<0.05)。结论对AMI合并焦虑情绪的急诊PCI术患者抗焦虑治疗更能缩短术后QTd,更显著改善RWMA。Objective To study the effect of anti-anxity treatment on QT dispersion （QTd） and regional wall motion abnbormality （RWMA） in patients with acute myocardial infarction （AMI） and emergency percutaneous coronary intervention （PCI）. Methods Fifty six patients with anxiety were admitted into our hospital for AMI during January 2005 to May 2007. The patients were randomly dioided into the anti-anxiety treatment （n=31） and the control group （n=28）. The QTd at 12-16 hours, 72-78 hours and 7 days after PCI, and the differences in RWMA at 7-10 days after anti-anxiety treatment were compared between the 2 group. Anti-anxiety treatment included prescription of midazolam and auxiliary systemic desensitization. Results Comparted with the control, the anti-anxiety treatment showed a less QTd at 12-16 hours （66±11 ms vs 70±10 ms, P0.01）, at 72-78 hours （37±4 ms vs 42±5 ms, P0.05） and at 7 days （31±4 ms vs 36±3 ms, P0.05） after PCI. The myocardial wall motion integral index in the treatment group was lower than that in the control group （1.5±1.1 vs 1.8±1.0, P0.05） after 7-10 days of treatment. Systolic thickening （30.1±15.2 vs 25.1±11.8, P0.05） and wall motion range （5.0±2.3 vs 4.8±2.1, P0.05） in the treatment group were higher than those of the control group.Conclusion Anti-anxiety treatment could shorten QTd and improve RWMA in the patients with emergency PCI.

关 键 词：心肌梗死 焦虑 血管成形术 经腔 经皮冠状动脉 

分 类 号：R541.4[医药卫生—心血管疾病]