| Objective：Through observing the variation of QT dispersion(QTd) of thepatients with acute myocardial infarction(AMI) who underwent emergency PCIbefore and after percutaneous coronary intervention(PCI) and recording theoccurrence of major adverse cardiac events(MACE) of all the patients withinten days in the hospital under different blood glucose levels,study the influenceof blood glucose level on the QT dispersion,and study the relationship betweenblood glucose level and the short-term major adverse cardiac events in AMIafter PCI.Methods：102cases of patients with AMI were underwent coronaryangiography by Judkin，s methods within12hours after admission,and theywere given PCI treatment according to the conventional methods both whosevascular stenosis reaching75%or higher and the vascular stenosis had clinicalsignificance according to coronary angiography.According to diabetes previousmedical history,the Haemoglobin A1c(HbA1c) after admission and theimmediate venous blood glucose level admitting to hospital,all patients weredivided into four groups according to group I: Without diabetes previousmedical history,HbA1c＜6.5%,blood glucose＜7.8mmol/L,26cases;GroupII:Without diabetes previous medical history,HbA1c＜6.5%,7.8mmol/L≤blood glucose＜11.1mmol/L,26cases;Group III:Without diabetes previous medicalhistory,HbA1c＜6.5%,blood glucose≥11.1mmol/L,26cases; DiabetesGroup:With diabetes previous medical history,HbA1c＞6.5%,blood glucose≥11.1mmol/L,24cases.Then measured the blood glucose level and the QTinterphase on the Electrocardiogram (ECG) in four time periods for all patientsrespectively,that is before PCI,1to2hours after PCI,6to24hours after PCI,24to48hours after PCI,and calculated the QTd. Meanwhile,observed thehappening of MACE of all the patients after PCI within10days in hospital.Results：(1) The QTd levels before PCI of all the groups were significantlyhigher than50ms,and the QTd of Group III and Diabetes Group weresignificantly greater than Group I and Group II,there had statistically significantdifference(P＜0.01). Group I and Group II had no statistically significantdifference(P＞0.05). The QTd levels between Group III and Diabetes Grouphad significant differences in different time after PCI (P＜0.01),except for theQTd levels between Group I and Group II.The QTd of all the groups wereextended in1to2hours after PCI and comparing with the QTd beforePCI,there was no statistically significant difference(P＞0.05).QTd wereshortened in6to24hours,24to48hours after PCI and comparing with the QTdof1to2hours after PCI and the QTd before PCI,there had statisticallysignificant difference(P＜0.01).And the degree of shortening of Group I andGroup II were higher than Group III and Diabetes Group.(2)The QTd of thefour groups were extended in1to2hours after PCI, and were shortened after2 hours after PCI,and had a shorten tendency over time.With respect to the degreeof shortening of the four groups, Group I and Group II were most obvious,thenext was Group III, Diabetes Group was minimum.(3)Observing the incidencerate of MACE of all the patients after emergency PCI within10days in hospital,Group III and Diabetes Group were significantly higher than Group I andGroup II,which had statistically significant difference(30.77%,37.50%VS3.85%,3.85%, P＜0.007).But the incidence rate of MACE between Group IIIand Diabetes Group had no statistically significant difference (30.77%VS37.50%, P＞0.007).Conclusion: In this study,through observing the QT dispersion before and afteremergency PCI and recording the occurrence of MACE in all patients underdifferent blood glucose levels,study the influence of blood glucose level on theQT dispersion,and the relationship between blood glucose level and theshort-term major adverse cardiac events in AMI after PCI. It suggests that bloodglucose level is an important factor in affecting the change of QTd and theshort-term prognosis of AMI patients after emergency PCI.To strengthenmonitoring and intervening the blood glucose level,it can reduce the occurrenceof major adverse cardiac events. |
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