肺心病患者QT离散度的研究

The Study on QT Dispersion in the Patients With Cor Pulmonale

目的 :探讨肺心病及肺心病患者的心功能状态及低氧血症对 QT间期离散度 (QT离散度 )的影响。方法 :分析了 5 1例肺心病患者及 2 8例健康对照者的 QT离散度、心电图、超声心动图及动脉血气分析。结果 :肺心病患者的 QT离散度显著高于正常对照者 ,两组分别为 (70 .1± 2 5 .8) ms和 (37.6± 12 .5 ) ms(P<0 .0 0 1) ;心衰患者的 QT离散度延长更为明显 ,为 (87.9± 2 1.6 ) m s,无心衰患者为 (5 1.7± 14.2 ) ms,两组比较差异非常显著 (P<0 .0 0 1) ;低氧血症对 QT离散度有显著影响 ,动脉血氧分压 (Pa O2 ) <8k Pa组和 Pa O2 ≥ 8k Pa组 QT离散度分别为 (81.0± 2 5 .9) m s和 (6 2 .1± 2 1.2 ) m s,两组比较有显著差异 (P<0 .0 1) ;肺心病患者的 QT离散度与右室内径大小显著正相关 (r=0 .489,P<0 .0 1)。结论

Objective:Our aim was to investigate the QT dispersion in patients with cor pulmonale and whether the QT dispersion was affected by cardiac function and hypoxemia of the patients with cor pulmonale. Methods:Fifty one patients with cor pulmonale and 28 age matched normal controls underwent electrocardiography, echocardiography, and arterial blood gas analysis. TheQTdispersionwas measured manually. Results:The QT dispersion was significantly longer in patients with cor pulmonale than those in the controls (70.1 ± 25.8 ms vs 37.6 ± 12.5 ms, P< 0.001). The QT dispersion in the patients with right heart failure was markedly longer compared with those with normal cardiac function (87.9 ± 21.6 ms vs 51.7 ± 14.2 ms, P< 0.001) . The QT dispersion was affected by hypoxemia. The QT dispersion in the groups of PaO 2< 8 kPa or ≥ 8 kPa was 81.0 ± 25.9 ms and 62.1 ± 21.1 ms, respectively. There was significant difference between the groups (P< 0.01). The QT dispersion was significantly correlated with the interior diameter of right ventricle in the patients with cor pulmonale (r= 0.489, P< 0.01). Conclusion: The QT dispersion may be a useful parameter in the diagnosis for cor pulmonale and in the assessment of cardiac function in the patients with cor pulmonale.