尿毒症患者Q—T离散度和T波峰末间期的研究

Detection of Q-T Dispersion and Tp-e Interval in Patients with uremia

目的探讨行维持性血液透析的尿毒症患者是否存在区域性和跨心室壁复极离散度（TDR）增大。方法分别测量行维持性血液透析的尿毒症患者（尿毒症组，n=35例）和正常健康者（对照组，n=40例）体表心电图的Q—T间期、R—R间期、丁波峰末问期（Tp—e），进而计算Q-T离散度（Q—Td=Q—Tmax—Q—Tmin）、心率校正的Q—T离散度（Q—Td／R√R--R），心率校正的最大Tp—e间期（Tp—emax／√R-R）、T波峰末问期离散度（Tp—ed=Tp—emax—Tp—emin）、心率校正的Tp—e间期离散度（Tp—ed／√R—R）。结果尿毒症组的Q—T离散度及校正的Q—T离散度较对照组明显延长（66．3±15．9VS40．2±12．4，681±14．8VS44．5±13．1。均P〈0．05）；尿毒症组的最大Tp—e间期及最大校正Tp—e间期较对照组明显延长（98．34-14．6VS77．6±12．1，94．2±12．6VS72，54-11．4，均P〈O．05），Tp—e间期离散度及校正的Tp—e问期离散度也较对照组明显延长（48．4±16．3VS32．1±12．3，44．3±12．2VS30．2±12．5，P〈0．05）。结论尿毒症患者的Q—T离散度和Tp—e间期及其离散度较正常者明显延长，表明尿毒症患者区域性和TDR增大。

Objective To determine whether presence of increased regional and transmural dispersion of ventricular repolarization in patients with uremia on maintenance hemodialysis. Methods QT interval, RR interval and T peak-to-end （Tpe） interval were measured and QT dispersion, corrected QT dispersion, corrected maximum Tpe interval, Tpe dispersion, and corrected Tpe dispersion were calculated based on ECG recorded in 35 patients with uremia on maintenance hemodialysis and 40 healthy subjects. Results QT dispersion, corrected QT dispersion, the maximum Tpe interval, corrected maximum Tpe interval, Tpe dispersion and corrected Tpe dispersion were significantly greater in patients with uremia than in healthy subjects. Conclusion Regional and transmural dispersion of ventricular repolarization increases in patients with uremia.