小儿心肌炎QT离散度的变化及其临床意义

The Clincal Value of QT Dispersion in Children with Myocarditis

目的 观察小儿心肌炎QT离散度 (QTd)的变化以及临床意义。方法 选择病毒性心肌炎患儿 4 9例 ,疑似心肌炎患儿 97例 ,做体表心电图及 2 4h动态心电图 (HOLter) ,测量 12导联的QTc max ,QTcmin ,计算QT离散度 (QTd) ;检查心肌酶谱AST ,LDH ,HBDH ,CK ,CK MB ,并进行相关性分析。结果 心肌炎与疑似心肌炎QTd差异有显著性 (P <0 .0 5 ) ,QTd增大主要发生在频繁室性早博 ,与其他心律失常的发生率差异有显著性 (P <0 .0 5 ) ,QTd与心率及心肌酶的变化无关 (P >0 .0 5 )。结论 QTd可以作为鉴别和估计心肌炎患儿心律失常性质及预后的辅助指标。

Objective To observe the change of QT dispersion(QTd) in children with myosaiditis and to determine its clinical value.Method 49 cases with viral myocaiditis and 97 cases doubted with myocaiditis were studied.All the subjests were performed routine ECG and Holter.The author measured maximum QT(QTmax) and minimum QT(QTmin) in the same lead.And the QTd is defined as the difference between QTmax and QTmin.At the same time,the author determined the plasma levels of myocardial enzyme such as AST,LDH,HBDH,CK,CK-MB.Then the author analysed whether there is correlation between the QTd and the levels of myocardial enzyme.Result There is statistical significance of QTd between myocarditis group and doubtful myocarditis group(P<0.05); There is statistical significance of QTd prolong between ventricle arrhythmia and other cardiac arrhythmia(P<0.05).There is no correlation between QTd and heart rate (P>0.05); Neither between QTd and the levels of myocarclial enzyme (P>0.05).Conclusion It is available that QTd is used as a supplementary index in the diagnosis and prognosis of myocarditis and cardiac ayyhythmia.