Tp-e/QT比值、低钾对扩张型心肌病患者室性心律失常的影响

The impacts of Tp-e/QT ratio, low potassium on ventricular arrhythmias in patients with dilated cardiomyopathy

目的 探讨Tp-e/QT比值、低钾对室性心律失常的影响.方法 将2008年1月至2013年12月入住我院的扩张型心肌病患者162例分为室性心律失常组（VA组）和非室性心律失常组（NVA组）,室性心律失常组又分为低钾组及血钾正常组.分析各组临床特点并观察超声指标及心电图V3、V4导联的Tp-e间期和Tp-e/QT比值的差异.结果 VA组左室舒张末期内径（LVEDD）较NVA组大[（72.88±6.81）mm比（62.67±4.91）mm,P＜0.05];左室射血分数（LVEF）VA组较NVA组低（0.24±0.04比0.32±0.05,P＜0.05）;NA组V3和V4导联Tp-e/QT比值均值均比NVA组大（0.268±0.050比0.216±0.016,P＜0.05）;低钾组V3和V4导联Tp-e/QT比值的均值均比血钾正常组大（0.291±0.047比0.260±0.048,P＜0.05）.随着Tp-e/QT比值的增加,多形性室速更易发生.结论 扩张型心肌病室性心律失常的发生与血钾浓度及Tp-e/QT比值有关,Tp-e/QT比值越大多形性室速越易发生.低钾时容易发生室性心律失常.

Objective To observe the effects of Tp-e/QT ratio, low potassium on ventricular arrhythmia. Methods Between January 2008 and December 2013 in our hospital. One hundred and sixty-two patients with DCM were divided into ventricular arrhythmia （VA） group and non-ventricular arrhythmia group （NVA）, and in VA group they were divided into low potassium and normal potassium group. The clinical characteristics and the Ultrasonic indexes, the difference of lead electrocardiogram （ECG） V3 and vg Tp-e/QT ratio were compared be- tween different group. Results The left ventricular end-diastolic diameter （LVEDD） in VA group was bigger than NVA group [ （72.88±6.81）mm vs （62.67±4.91）ram, P〈0.05 ]. The left ventricular ejection fraction in VA group were lower than NVA group[（0.24±0.04） vs （0.32±0.05）, P〈0.05]. The Tp-e/QT average ratio in lead V3 and V4 were higher than NYA group[ （0.268±0.050） vs （0.216±0.016）, P〈0.05]. Tp-e/QT average ratio of leads V3 and vg in low potassium were higher than normal potassium group [ （0.291±0.047） vs （0.260±0.048）, P〈0.05 ]. With the increase of Tp-e/QT ratio polymorphous ventricular tachycardia were more likely to happen. Conclusion The occurrence of ventricular arrhythmia is correlate with potassium concentration and ratio of Tp-e/QT. Tp-e/QT ratio, the greater the polymorphous ventricular tachycardia is easily occurred, when low potassium prone to ventricular arrhythmias. In patients with dilated cardiomyopathy echocardiography, electrocardiography, electrolytes andother indicators can be further risk stratification.