高血压伴左室肥厚的QT离散度分析

ANALYSIS OF QT DISPERSION IN PRIMARY HYPERTENSION WITH LEFT VENTRICULAR HYPERTROPHY

目的:研究原发性高血压伴左室肥厚的左室重量(LVM)对QT间期离散度(QTd)的影响及QTd对室性心律失常的预测作用。方法:检测146例患者的QT、JT、OTc、JTc离散度和超声心动图,其中98例行24h动态心电图监测。结果:原发性高血压的复极离散度大小与左室重量呈正相关,伴左室肥厚者(LVH组)的QTd大于无左室肥厚者(对照组)(P<0.01),有持续性室速发生者(SVT组)的复极离散度大于无室性心律失常者(对照组)(P<0.01),仅有室性期前收缩者(VPC组)的QTd与对照组无明显差异(P>0.05)。结论:复极离散度的大小主要与左室重量有关,伴左室肥厚者的心性猝死率增加可能与QTd的增大有关,QTd的变化可作为原发性高血压恶性室性心律失常的预测指标。

Objective ： To study the influence of left ventricular mass （LVM） in QT dispersion （QTd） of primary hypertension with left ventricular hypertrophy and the value of QTd in the prediction of ventricular arrhythmias. Methods ： 146 patients were determined for their QT, JT, Qtc, JTc dispersion and ec-chocardiograms, in 98 patients, AEGG were observed in 24 hours. Results： In primary hypertension, the size of repolarized dispersion was positive relation with left ventricular mass;the QTd of left Ventricular hypertrophy（LVH group） was greater than that of no left ventricular hypertrophy（P 〈0. 01 ） Conclusions：The size of repolarized dispersion is mainly related with left ventricular mass. The increase of the rate of cardiac sudden death is probably related with enlargement of QTd. Thus, the change of QTd-can be used as a parameter in malignant ventrieular arrhythmias with primary hypertension.