单纯性肥胖儿童心电图QT离散度与左心室射血分数的关系研究

Relationship between QT dispersion and left ventricular ejection fraction in simple obese child

【目的】 分析单纯性肥胖儿童是否存在心电图QT离散度 (QTD ,QTcD)的改变及其可能的临床应用价值。 【方法】 测量单纯性肥胖组和对照组儿童 12导联心电图RR间期、QT间期并计算QTc、QTD、QTcD ,彩色多普勒测量受试者左室射血分数 (LEF)。 【结果】 肥胖组RR、LEF明显低于对照组 (P <0 .0 1,P <0 .0 0 1) ,QTcD明显高于对照组 (P <0 .0 5 ) ,QTD虽然比对照组大 ,但无统计学意义 (P >0 .0 5 ) ;肥胖组QTD、QTcD与LEF成负相关关系 (r = 0 .485 ,P <0 .0 5 ;r = 0 .5 12 ,P <0 .0 5 ) ,与RR成正相关关系 (r =0 .5 2 0 ,P <0 .0 2 ;r =0 .613 ,P <0 .0 0 5 )。 【结论】 肥胖儿童LEF降低 ,心率增快 ,QTcD显著延长 ;QTD、QTcD的变化可能是肥胖儿童心室肥厚、心肌脂肪浸润等某一或某几项病理改变及心率变化的综合反映 。

To evaluate whether QT dispersion change was already present in children with simple obesity and its potential clinical utility. RR interval,QT interval,QTc,QTD,QTcD were measured respectively in 20 children with simple obesity and in 24 sex and age matched control subjects; LEFs were also measured in all subjects. Children with simple obesity had significantly shorter RR intervals( P <0.01) ,lower LEFs( P <0.001) and longer QTcDs( P <0.05).QTDs in children with simple obesity were a little more longer than in control subjects,but had no statistic significance( P >0.05).A significant negative correlation existed between QT dispersion( QTD and QTcD)and LEF( r = 0.485,P<0.05; r = 0.512, P <0.05;respectively), a positive correlation existed between QT dispersion(QT and QTcD)and RR interval( r =0.520, P <0.02; r =0.613, P <0.005;respectively). [Conclusions] Children with simple obesity have lower LEFs,faster heart rates and larger QTcDs. The prolonged QTD and QTcD may be predictive indicators of the cardiomyopathy and LEFs in child with simple obesity.