不同负荷频发室性期前收缩患者血尿酸、QTCB、左室心肌质量指数比较分析

Comparative analysis of uric acid,QTCB and left ventricular myocardial mass index in different burden of frequent premature ventricular contractions

目的通过比较不同负荷频发室性期前收缩(premature ventricular contraction,PVC)患者血尿酸(uric acid,UA)、左室心肌质量指数(left ventricular myocardial mass index,LVMI)、校正QT间期(correct QT interval by Bazett,QTCB),探讨期前收缩负荷与这些指标之间的关系。方法入选期前收缩频次大于360次/h或8 640次/24 h室性心律失常患者67例,研究对象均行24h动态心电图监测及空腹接受化验检查,将入选患者分为期前收缩负荷<10%(低负荷组)、10%～20%(中等负荷组)、>20%(高负荷组),比较3组间生物化学指标、LVMI、心电图指标等分析其相关性。结果高负荷组QTCB、LVMI、UA水平明显高于低负荷组(P<0.01),经多元线性回归分析结果得出回归方程Y=0.029X1+0.045X2-12.558,F=10.037,P<0.001(Y=期前收缩负荷,X1=UA,X2=QTCB),标准化回归系数UA为0.357,QTCB为0.295。结论 PVC患者随着期前收缩负荷的增加,QTCB延长、左室肥厚程度加重,UA水平升高,并且对期前收缩负荷的影响UA比QTCB大。

Objective To observe the relationship between uric acid （UA）, Bazett-corrected QT interval （QTCB） and left ventricular myocardial mass index （LVMI） in different burden of frequent premature ventricular contractions. Methods A total of 67 patients with frequent PVCs （PVC beats more than 360 t/h or 8 640 t/d） were enrolled, and in all subjects dynamic-electrocardiogram and laboratory examination were performed. The patients were divided into three groups by the burden of PVCs： the lower burden group （〈10%）, the medium burden group （10%~20%）, and the higher burden group （〉20%）. LVMI, laboratory indexes, and QTCB were compared among the 3 groups. Results Compared with the lower burden group, QTCB, LVMI, UA in the higher burden group were significantly increased （P〈0.01）, the equation of liner regression is Y=0.029X1＋0.045X2-12.558, F=10.037, P〈0.001 （Y=burden of PV,X1=UA, X2=QTCB）,the standardized coefficients is UA=0.357, QTCB=0.295.Conclusion With contraction burden increased, UA, QTCB level and the degree of left ventricular hypertrophy increased, in the contraction burden, UA effects was greater than that of QTCB.