| Background Acute coronary syndrome is a group based on coronaryatherosclerosis,plaque rupture, thrombosis, embolism in or vasospasmpathophysiological characteristics of clinical acute myocardial ischemic eventssyndrome. Its clinical manifestations include: unstable angina, acutemyocardial infarction or sudden death. With the clinical features of acute onset,severe illness, mortality. Most of the patients according to the typical clinicalmanifestations, typical ECG, serum myocardial necrosis markers, such ascoronary angiography can confirm the diagnosis means. Little clinicalmanifestations in some patients were not typical, and even lead tomisdiagnosis. And acute coronary syndrome related death and ECG instabilityof malignant ventricular arrhythmia, especially the persistent ventricularHeartbeat tachycardia, ventricular fibrillation can lead to sudden death inpatients with.Routine ECG examination has the advantages of simple, rapid,noninvasive,inexpensive, diagnosis and treatment of cardiovascular diseasesin field application has a long history, also plays a unique and irreplaceablerole in the diagnosis of coronary heart disease and acute coronary syndrome.Scholars have noted that many common cardiovascular disease may result inchanges of electrocardiogram QT dispersion, research has also found thatacute coronary syndrome electrocardiogram also can appear the change ofQT dispersion.This paper aims to explore the change of QT dispersion in acute coronarysyndrome in acute myocardial ischemia; changes of QT dispersion in differentlevels of severity of coronary artery stenosis; changes of QT dispersion before and after PCI; and after PCI is applied for Luo non class on QT dispersionchanges have no effect. In order to evaluate the changes of electrocardiogramQT dispersion in acute coronary syndrome diagnosis and treatment ofproviding more reference resourcesObjective Observation:1, acute coronary syndrome (ACS) in ECG QTdispersion (QTd and QTcd) changes;2, the change of different severity ofcoronary artery stenosis of QT dispersion;3, acute myocardial infarction afterpercutaneous coronary intervention (percutaneous coronary intervention, PCI)changes of QT dispersion technique before and after the use of non class; Luo,the changes of QT dispersion in4, acute myocardial infarction patients afterPCI. To investigate the change of QT dispersion syndrome in the diagnosisand treatment of acute coronary arteryMethods A retrospective analysis of the clinical data of272cases diagnosedin2010February to2013June underwent coronary angiography in patientswith acute coronary syndrome, measurement and analysis of the ECG QTdispersion and QTc dispersion value.40patients with chest tightness, chestpain symptoms of coronary arteriography examination to exclude coronaryheart disease as control group. Observation on the changes of QT dispersionon134cases of unstable angina pectoris in different extent of coronary arterystenosis (one or two, three lesions). To observe the changes in36cases of QTdispersion before and after myocardial infarction and PCI treatment degree.Observation on the changes of QT dispersion which30cases of PCI with usedfor tirofiban and in36PCI patients for tirofiban unused.Results Acute coronary syndrome than normal coronary artery group QTd,QTcd values increased value of surface electrocardiogram QTd and QTcdsyndrome group. Unstable angina group, two-vessel group QTd, QTcd valuethan a vessel group increased, three lesions in group QTd, the QTcd value ismore than double branch lesion group, myocardial infarction group QTd andQTcd compared with normal coronary artery group numerical value increasedsignificantly. After PCI QTd, its QTcd value was lower than that in PCI normal group before operation, close approximation. PCI group applied for Luo nonclass after the QTd, QTcd value is not used for Luo non team is small, theapplication of GP Ⅱ b/Ⅲ a receptor antagonist for Luo non class cansignificantly reduce the ischemic myocardial QT dispersion indicates that PCIoperation, improve the prognosis.Conclusion①The QTd and QTcd in patients with Unstable type angina and acutemyocardialinfarction was significantly prolonged, indicate that acute coronarysyndrome of a different degree of myocardial ischemia on QT dispersionincreases.②The QTd and QTcd values and coronary artery lesion only number, the QTdand QTcd numerical value is greater, may indicate coronary artery lesion inonly a few more and more serious, ischemia.③Acute myocardial infarction for effective percutaneous coronary arteryinterventional reperfusion therapy (percutaneous coronary intervention, PCI)was significantly reduced in QT dispersion, show that: myocardial ischemiamay lead to ventricular repolarization inhomogeneity, revascularization aftersuccessful reperfusion therapy on QT dispersion is reduced, there isconducive to the stability of myocardial electrophysiology.④The tirofiban was significantly Used for shortened the QT dispersion inpatients with acute myocardial infarction underwent PCI surgery andpostoperative, the application of GP Ⅱ b/Ⅲ a receptor antagonist fortirofiban effectively inhibited platelet aggregation showed PCI, so as to exertantithrombotic effects, the ischemic myocardial blood flow and tissue perfusionfunction improved significantly electrophysiological, stabilizing myocardialischemia and patients get benefit more.⑤To Testing the changes of QT dispersion In acute coronary syndrome mayreflect the electrophysiological stability condition of myocardial ischemia. PCIpostoperative local myocardial blood supply was improved, reduced QTdispersion, may change the ECG of acute coronary syndrome instability, be beneficial for to reduce the incidence of sudden death of ventriculararrhythmia. |
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