心肺复苏患者QT间期变化及其与恶性心律失常的关系

Study on QT interval change and its relationship with malignant arrhythmias in cardiopulmonary resuscitations

目的:研究心肺复苏(CPR)者QT间期变化规律及其与恶性心律失常(MA)的关系,探讨胺碘酮干预继发性QT间期缩短患者,恢复自主循环(ROSC)后MA的发生率,为心脏骤停(CA)的防治提供依据。方法:回顾性分析60例CA行CPR、ROSC患者的心电图资料。结果:(1)CA前患者ROSC即刻的QT间期、QTc间期及JT间期、JTc间期较入院时明显缩短,差异有统计学意义(P<0.05)。(2)MA组和非MA组患者CA前和ROSC即刻QT间期及QTc间期均明显缩短,而MA组CA前及ROSC即刻的QT间期和QTc间期缩短更明显,差异有统计学意义(P<0.05)。(3)继发性QT间期缩短患者经胺碘酮治疗后,ROSC后MA的发生率无明显差异。结论:心肺复苏患者CA前及ROSC即刻QT间期缩短,MA患者QT间期缩短更明显,胺碘酮对继发性QT间期缩短患者ROSC后MA的发生无影响。

objective：To study QT interval change and its relationship with malignant arrhythmias（MA） in cardiopulmonary resuscitations;To explore the incidence of MA by amiodarone intervention after restoration of spontaneous circulation（ROSC） among patients with subsequent QT shortening,and provide evidence for the prevention and treatment of cardiac arrest（CA）.Methods：Retrospective analysis of ECG data of 60 patients with CA underwent CPR and ROSC.Results：（1）QT interval,QTc interval,JT interval,and JTc interval were significantly shortened before CA and instantly after ROSC（P〈0.05）.（2） For both MA group and non-MA group,QT interval and QTc interval were significantly shortened before CA and instantly after ROSC（P〈0.05）.Moreover,the QT interval and QTc interval shortening were more obvious in group MA than in non-MA group.（ 3）For patients with subsequent QT shortening,when treated with amiodarone,the incidence of MA after ROSC was not significantly reduced.Conclusion：QT intervals are significantly shortened before CA and instantly after ROSC,which is more obvious in patients with MA.Amiodarone has no effect on the occurrence of MA in patients with secondary QT interphase shorten after ROSC.