Brugada综合征患者体温与QT间期相关性研究及临床意义

Correlation between the body temperature and QTc in patients with Brugada syndrome and it＆#39;s clinical implications

目的 探讨Brugada综合征（BrS）患者不同体温状态对心电图校正的QT间期（QTc）的影响,并对两者进行相关性分析,阐述其可能的机制及临床意义.方法 选择2008年5月至2013年5月在南京医科大学第一附属医院明确诊断的BrS患者为实验组,以年龄、性别相匹配的阵发性室上性心动过速（PSVT）患者为对照组,对每例患者均每日多次测量体温并同时行心电图检查,采用Bazett公式计算QTc,将体温和QTc关系绘制成散点图并进行相关性检验.结果 8例BrS患者均为男性,平均年龄（47.38±15.05）岁,均有晕厥史,有家族猝死史（1例）,临床记录室性心动过速（VT）或心室颤动（VF）4例,电生理检查（EPS）诱发VT或VF 5例.8例PSVT患者（男女比例为4∶4）,平均年龄（43.75±10.47）岁,房室结折返性心动过速5例,房室折返性心动过速3例.BrS组体温与QTc之间具有相关性,相关系数0.6（P＜0.05）,而对照组两者之间无相关性（P＞0.05）.结论 BrS患者体温与QTc呈正相关,随着体温的升高,QTc呈升高趋势,容易发生室性心律失常.

Objective The aim of this study was to investigate the correlation of body temperature with QTc in patients with Brugada syndrome（BrS）,and also explore its clinical implication.Methods The patients with BrS admitted at our institution from May 2008 to May 2013 were regard as the experimental group（BrS group）,and age and sex-matched patients with paroxysmal supraventricular tachycardia（PSVT） were enrolled into the control group.Body temperature of each patient was multiple sites measured daily.Electrocardiogram examination was consisted with body temperature measurement.Bazett formula was used to calculate QTc.We drew the scatter diagram and did the correlation analysis for the body temperature and QTc in two groups,respectively.Results Eight patients with BrS were male,mean age （47.38± 15.05）years,all of them had a history of syncope.Of them,one patient had family history of cardiac sudden death,4 patients were documented ventricular tachycardia（VT） or ventricular fibrillation（VF）,and 5 patients with VT or VF induced by electrophysiological test （EPS）.Eight patients in PSVT group,mean age was （43.75±10.47）years,of them 5 patients with atrioventricular nodal reentrant tachycardia,3 patients with atrioventricular reentrant tachycardia.In BrS group,the body temperature was strong correlation with QTc,r =0.6 （P〈0.05）.However,there was no correlation between them in the control group（P〉0.05）.Conclusion There was positive correlation between body temperature and QTc in patients with BrS.With temperature increasing,QTc prolonged,VF/VT was easily induced.