QT离散度对急危重病人预后的评估

Significance of QT dispersion for prognosis in the critical illness

目的 研究QT离散度对急危重病人预后的预测价值。方法 死亡组 4 7例、疾病组 4 0例和正常组 4 3例。记录 12导联心电图 ,人工测量各导联R -R间期和QT间期 ,计算R -R、QTc、QTd和QTcd。结果 死亡组的R -R、QTc、QTd和QTcd分别为 0 5 6 2± 0 2 2 0ms、0 35 6± 0 0 6 9ms、0 0 5 6± 0 0 33ms和 0 0 79± 0 0 4 6ms ;疾病组的R -R、QTc、QTd和QTcd分别为0 80± 0 134ms、0 4 16± 0 0 3ms、0 0 34± 0 0 14ms和 0 0 39± 0 0 16ms;正常组的R -R、QTc、QTd和QTcd分别为 0 82 5± 0 0 88ms、0 4 0 2± 0 0 3ms、0 0 2 7± 0 0 15ms和 0 0 31± 0 0 15ms。比较死亡组、疾病组和正常组发现 ,死亡组和疾病组的R -R、QTc、QTd和QTcd存在显著差异 (P分别 <0 0 0 1、<0 0 0 2 5、<0 0 0 1和 <0 0 0 1)。死亡组和正常组的R -R、QTc、QTd和QTcd存在显著差异 (P分别 <0 0 0 1、<0 0 0 2 5、<0 0 0 1和 <0 0 0 1)。结论 QTd对急危重病人的预后有一定的预测价值 ;但其它临床应用价值存在局限性 ,有待进一步探索。

Objective To determine significance of QT dispersion for prognosis in the critical illness. Methods There were 47 cases in the death group, 40 cases in the disease group and 43 cases in the normal group. 12-lead ECG was recorded in all cases. R-R interval and QT interval were measured by hands. R-R, QTc, QTc and QTcd were obtained by calculation respectively. Results In the death groups, R-R, QTc, QTc and QTcd were 0. 62±0.220 ms, 0.3 6±0.069 ms, 0.0 6±0.033 ms and 0.079±0.046 ms respectively; In the disease groups, R-R, QTc, QTc and QTcd were 0.80±0.134ms , 0.416±0.03 ms, 0.034±0.014 ms and 0.039±0.016 ms respectively; In the normal group, R-R, QTc, QTc and QTcd are 0.82 ±0.088 ms, 0.402±0.03 ms, 0.027±0.01 ms and 0.031±0.01 ms respectively. R-R, QTc, QTc and QTcd showed obvious difference between the death group and the disease group (P<0.001, <0.002 , <0.001 and <0.001 respectively). R-R, QTc, QTc and QTcd showed obvious difference between the death group and the normal group ( P<0.001, <0.002 , <0.001 and <0.001 respectively). Conclusion QT dispersion has predictable value in prognosis of the serious illness, but the values of clinical use is limited. [