充血性心力衰竭QT离散度增加与猝死关系

Relations between QT dispersion(QTd) andsudden death in the congestive heart failure

目的探讨充血性心力衰竭QT离散度(QTd)与猝死关系。方法选择心功能均为Ⅲ级或Ⅳ级猝死者和存活者各30例 ,分别测定入院时、临近猝死时、出院时心电图QTd、QTc离散度(QTcd)的动态变化。结果入院时猝死组QTd(83±21 13ms)、QTcd(97±23 31ms)显著高于存活组(39±17 11ms、41±20 28ms) ,p<0 01 ;猝死组随着时间推移QTd、QTcd逐渐增加 ,临近猝死时QTd(105±22 2ms)、QTcd(122±24 17ms) ,与入院时比较 p<0 01 ;而存活组QTd、QTcd逐渐降低 ,出院QTd(32±17 1ms)、QTcd(33±19 21ms) ,与入院时比较p<0 05。结论充血性心衰猝死者QTd、QTcd均较存活期显著增加 ,且随着时间推移逐渐增加 ,而存活者经有效治疗后随心功能改善呈下降趋势。因此 ,动态观察QTd、QTcd的变化 ,可以预测心衰患者猝死的发生、心功能状态及评价药物疗效。

Objective:To investigate the relations between QT dispersion(QTd) and the Cardiac sudden death in congestive heart failure.Methods:To select cardiac sudden death cases 30 and the living cases 30 with cardiac function stage Ⅲor Ⅳ,monitor QTd of each case when sent to hospital,just before death and leave hospital.Results:When sent to hospital,QTd(83±21.13ms).QTcd(97±23.31ms) in death group were significantly longer than those in the living group(39±17.11ms, 41±20.28ms),P<0.01,QTd and QTcd become longer and longer in the death group,When just before death, QTd (105±22.23ms) and QTcd(122±24.17ms) were significantly longer,compared with those when sent to hospital; In the living group, QTcd become shorter and shorter, when leave hospital,QTd(32±17.13ms), QTcd(33±19.21ms) were significantly shorter,compared with those when sent to hospital, P<0.05. Conclusion:In congestive heart failure, QTd and QTcd of the sudden death cases, were significantly higher:and gradually increase while stage of illness advanced, but in the living case through treated effectively, their cardiac function have improved, QTd and QTcd can be serve as a maker to predict Occurence of sudden death, condition of cardiac function and value for effective of treatment.