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目的探讨老年急性心肌梗塞（ＡＭＩ）早期心电图ＱＴ离散度（ＱＴｄ）变化特点，ＱＴｄ与临床表现的关系，以及ＱＴｄ对预后的意义。方法测量老年ＡＭＩ组和非老年ＡＭＩ组各５０例及老年无心脏病组５４例１２导联心电图ＱＴｄ（ＪＴｄ），即ＱＴ间期（ＪＴ）最大值与最小值之差，计算出ＱＴｃｄ（ＪＴｃｄ）。结果老年ＡＭＩ组ＱＴｄ（ＪＴｄ）与其他２组分别有非常显著性差异（Ｐ＜０．００５～０．００１）。两ＡＭＩ组死亡与生存者ＱＴｄ（ＪＴｄ）均有显著、非常显著性差异（Ｐ＜０．０５～０．０１）。老年ＡＭＩ组重度泵衰竭、室性心律失常发生率及死亡率高于非老年ＡＭＩ组。结论ＱＴｄ（ＪＴｄ）可作为判断ＡＭＩ患者病情与预后的一项有价值的指标，对老年ＡＭＩ患者更具有临床意义。
Objective To investigate the characteristics of early QTd in elderly patients with acute myocardial infarction (AMI), the relationship between QTd and clinical manifestations, and the significance of QTd in prognosis. Methods The QTd (JTd), the difference between the maximum and minimum of QT interval (JT), was calculated in 50 senile AMI patients and 50 senile AMI patients and 54 senile patients without heart disease. QTcd (JTcd) . Results The QTd (JTd) of AMI group was significantly different from the other two groups (P <0.005 ~ 0.001). The death and survivors QTd (JTd) between the two AMI groups were significant, very significant difference (P <0.05 ~ 0.01). Severe pump failure, ventricular arrhythmia and mortality in the elderly AMI group were higher than those in the non-elderly AMI group. Conclusions QTd (JTd) can be used as a valuable index to judge the condition and prognosis of patients with AMI. It is more clinically significant for elderly patients with AMI.