冠状动脉旁路移植术对QT离散度的影响及其临床价值  

Changes and clinical value of QT dispersion in electrocardiogram after coronary artery bypass grafting

作　　者：李红卫[1] 常新[1] 赵根尚[1] 张冰慧[1] 

机构地区：[1]郑州大学第二附属医院心血管外科,郑州450014

出　　处：《临床心血管病杂志》2016年第8期769-772,共4页Journal of Clinical Cardiology

摘　　要：目的：观察冠状动脉旁路移植术（CABG）对QT离散度（QTd）的影响,探讨其临床价值。方法：选取39例行CABG成功的患者作为实验组,测量分析其术前7d、术后1~7d以及14d的QTd及心率校正的QT离散度（QTcd）的变化,同时观察左室射血分数（LVEF）的变化及心绞痛缓解程度,并以42例冠状动脉造影确诊为冠心病而暂未行血运重建术患者作为对照组。结果：CABG患者术前的QTd较正常参考值明显增加,术后3d内的QTd与术前相比,均有增加,其中以术后2d为最高,QTd在术后4d开始下降,术后7dQTd已低于术前水平,术后14d继续降低,且QTd的减少与LVEF的增加及心绞痛缓解程度存在相关性。结论：CABG能使QTd减少,QTd在CABG术前病情判断及评价血运重建术效果中有一定价值。Objective：To study the changes and clinical value of QT dispersion（QTd）in electrocardiogram after coronary artery bypass grafting（CABG）.Method：The changes of QTd in thirty-nine patients with CABG were monitored by 12-lead electrocardiogram system on 7dbefore surgery,1-4dand 7dand 14 dafter surgery.At the same time the degree of angina pectoris and left ventricular ejection fractions（LVEF）were observed.Forty-two patients diagnosed with coronary heart disease by coronary angiography and not treated with revascularization were enrolled as control group.Result：The QTd of patients with CABG on 7dbefore surgery was significantly increased compared with the normal level.The QTd after surgery was significantly higher compared with the preoperative,and the highest level occurred on the 2nd day after surgery.QTd began to decrease on the 4th day after surgery and it was significantly lower on the 7th day as compared with the preoperative.There was a continuous decrease on the 14 th day after surgery.The decreased QTd was correlated with increased LVEF and angina relief.Conclusion：CABG can decrease QTd.The QTd has a certain value on the preoperative assessment of CABG and assessing the effect of revascularization.

关 键 词：QT离散度 冠状动脉旁路移植术 心肌顿抑 

分 类 号：R541.4[医药卫生—心血管疾病]