肝硬化患者QT离散度的改变

The change of QT dispersion in patients with liver cirrhosis

目的观察肝硬化患者体表心电图QTd改变及其与肝功能的关系。方法70例肝硬化患者,年龄(51.8±10.0)岁,按Child-Pugh肝功能分级标准分为Child A组(n=24),Child B组(n=24)和Child C组(n=22)。30例健康体检者作对照组,年龄(48.4±9.3)岁。记录12导联同步心电图,测量QT间期,根据心率计算校正的QT间期(QTc);QTcd等于最大QTc减最小QTc。比较各组QTcd均值及QTcd延长(≥50ms)患者的比例。结果对照组、Child A组、Child B组、Child C组QTcd(ms)分别为37.±54.9,38.9±4.6,46.7±7.0,53.6±8.0;对照组和Child A组无QTcd≥50ms者,Child B组和Child C组QTcd延长者分别为25.0%和54.5%。对照组和Child A组比较无QTcd明显差异(P>0.05),Child B组和Child C组皆较对照组和ChildA组增大(均P<0.01);Child C组较之ChildB组QTcd进一步加大(P<0.01),QTcd延长者比例增加(P<0.05)。结论肝硬化患者QTd增大,与肝功能损害严重程度相一致。

Objective To assess the change of QT dispersion （QTd） in patients with liver cirrhosis, and the relationship between QTd and the Liver function. Methods 70 patients （51.8 ±10.0 years old） with liver cirrhosis were divided into A（ n=24 ）, B（n=24） and C （n=22）group according to the Child-Pugh score, and the rate-corrected QT division （QTcd） was calculated. 30 healthy （48.4 ± 9.3 years old） were regarded as the control group. Results The QTcd of group control, Child A ,Child B and Child C was 37.5 ± 4.9,38.9 ± 4.6,46.7 ± 7.0and 53.6 ± 8.0 respectively. No QTcd≥ 50 ms in group control and group Child A. The lengthen QTcd in group Child Band Child C was 25.0%和54.5%. There was no difference between group A and control （P〉0.05）. QTcd in Child C group and Child B group was longer than either in Child A and Control （P〈0.01）.The rate of QTcd prolonged patients in Child B group was lower than that in Child C group （P〈0.05）. Conclusion QTd tends to increase in patients with cirrhosis, and the divided degree of QT interval is coincidence with the damage of liver function.