目的：探讨直接经皮冠状动脉腔内成形术(P-PTCA)对急性心肌梗塞早期24小时心电稳定性的影响。

方法：对发病≤6小时接受P-PTCA治疗的急性心肌梗塞患者22例进行动态心电图监测，持续观察其24小时QT间期值(QT)、心率校正的QT(QTc)和室性心律失常变化，并与梗塞相关动脉(IRA)未通患者15例作对比。

结果：接受P-PTCA治疗的患者在IRA开通的同时，于再灌注早期QTc显著延长并伴有频发的室性心律失常。

结论：P-PTCA的较早期心电不稳定性增加，此为IRA开通和心肌再灌注损伤的临床有力指标之一。

The Intervention of Primary Percutaneous Transluminal Coronary Angioplasty to the Stability of Cardiac Electricity in the Early Acute Myocardial Infarction during the First 24 Hours (Abstract)

The Heart Center, Beijing Red Cross Chaoyang Hospital, The Institute of

Cardiovascular Disease, Capital University of Medical Sciences, Beijing (100020)

Li Reijie, Hu Dayi, Guo Chengjun, et al.

Objective: To investigate the effects of primary percutaneous transluminal coronary angioplasty (P-PTCA) on the stability of cardiac electricity in the early acute myocardial infarction (AMI) during the first 24 horus.

Methods: Twenty two patients (16 males and 6 females, aged 42～74) with AMI and treated by P-PTCA underwent 24 hours, Holter monitoring within 6 hours after the symptom onset. The changes of QT interval (QT), corrected QT for heart rate (QTc) and ventricular arrhythmia were analyzed continuall, and was compared with the 15 patients (12 males and 3 females, aged 46～68) who had occluded infarctrelated arteries (IRA).

Results: Frequent ventricular arrhythmia and markedly prolonged QTc were observed during the early reperfusion in patients with IRA reoperied by P-PTCA.

Conclusion: The increased unstability of cardiac electricity was showed in the early phase after PTCA. This is a strong clinical marker for IRA reopening and myocardial reperfusion damage.