血液透析和腹膜透析患者QT离散度比较

Comparison of QT dispersion between hemodialysis and peritoneal dialysis patients

目的比较血液透析(HD)和腹膜透析(PD)患者的QT离散度(QTd)。方法选取透析治疗6个月以上的HD患者、PD患者及健康对照者各40例,检测QTd、实验室检查指标及左室结构及功能指标,并计算校正QTd(QTdc)与左心室肥厚质量指数(LVMI)。结果 HD和PD患者QTd分别为(51.1±6.3)ms、(48.2±6.4)ms,显著高于对照组(37.6±4.3 ms,P均<0.05);QTdc分别为(59.1±6.3)ms、(54.5±6.5)ms,显著高于对照组(43.6±5.5 ms,P均<0.01),但HD和PD组间差异无统计学意义(P>0.05)。PD患者LVMI值(119.6±16.6)g/m2显著高于对照组(91.6±14.1 g/m2,P<0.05),且LVMI与QTd(r=0.51,P<0.01)、QTdc(r=0.56,P<0.01)呈正相关;HD组患者LVMI与对照组无差异,与QTd、QTdc无相关性。结论 HD和PD患者QTd、QTdc增高,PD患者LVMI与QTd、QTdc有相关性,且有可能作为PD患者危险因素监控的指标。

Objective To compare the QT dispersion (QTd)between patients treated with hemodialysis and peritoneal dialysis. Methods 80 cases of patients treated with hemodialysis or peritoneal dialysis for more than 6 months (40 cases in each group)and 40 healthy control subjects were recruited in the study.The QTd,routine laboratory tests and indicators of left ventricular structures and function of all participants were detected,and then the corrected QTd (QTdc)and left ventricular mass index (LVMI)were calculated.Results The QTd values of hemodialysis or peritoneal dialysis patients were (51.1 ±6.3)ms,(48.2 ±6.4)ms respectively,and were significantly higher than those of the control group (37.6 ±4.3 ms,P<0.05 ).The QTdc values of hemodialysis or peritoneal dialysis patients were (59.1 ±6.3)ms,(54.5 ±6.5)ms respectively,and were also significantly higher than the control group (43.6 ±5.5 ms,P<0.01),but the QTd and QTdc values between the hemodialysis group and the peritoneal dialysis group showed no significant difference (P>0.05 ).The LVMI values of peritoneal dialysis group (119.6 ±16.6 g/m2)were significantly higher than the control group (91.6 ±14.1 g/m2,P<0.05),and were positively related to the values of QTd (r=0.51,P<0.01)and QTdc (r=0.56,P<0.01)of peritoneal dialysis group, but the LVMI values of hemodialysis group were not significantly different with the control group,with no relation to the QTd and QTdc values of hemodialysis group.Conclusion The QTd and QTdc values of patients treated with hemodialysis or peritoneal dialysis would increase. The LVMI values of peritoneal dialysis patients are positively related to their QTd and QTdc values and could be used as a risk-monitoring indicator in patients with peritoneal dialysis.