慢性肾衰规律血透患者QT间期离散度与室性心律失常的相关性研究

The correlation between QT dispersion and ventricular arrhythmias in regular hemodialysis patients with renal failure

目的研究65例慢性。肾衰竭行规律血液透析的患者透析前后QT间期离散度（QTd）的变化以及QTd与室性心律失常的关系。方法65例血透患者分为有室性心律失常组及无室性心律失常组，记录患者透析前及透析后心电图并计算QTd值，同时记录临床参数并检测相关实验室指标，最后进行统计学分析处理。结果存在室性心律失常的血透患者较无室性心律失常患者透析前QTd显著增高（P〈0．01）；透析后QTd较透析前明显增加（P〈0．01）；透析后QTd的增加程度与透析前后钾离子浓度及二氧化碳结合率（CO2CP）的变化程度呈显著正相关。结论血透患者室性心律失常的发生与QTd的增加有关；血透中QTd进一步增大，可能与钾离子浓度快速变化以及酸中毒的快速纠正有关。

Objectives To investigate the change of QT dispersion （QTd） in 65 patients with renal failure undergoing regular hemodialysis, the relationship between QTd and ventricular arrhythmia in those patients. Methods 65 hemodialysis patients were divided into two groups： patients with ventricular arrhythmia group and patients without ventricular arrhythmia group. ECG were carried out before and after dialysis, and QTd were calculated. Meanwhile, clinical parameters and indexes of laboratory examinations were recorded. Finally, experimental data were statistically analyzed. Results Before hemodialysis, QTd in patients with ventricular arrhythmias had a significant higher than in patients without ventricular arrhythmia（ P 〈 0.01 ）. Post - hemodialysis values of QTd had a significant higher than pre -hemodialysis values（ P 〈0.01 ）. It is shown that the extension of QTd was correlated with the change of K^＋ concentration and CO2 CP. Conclusions Increasing of QTd in hemodialysis patients may be related to the occurrence of ventricular arrhythmias. QTd extension during hemodialysis may due to the rapid change of K^＋ concentration and rapid correction of acidosis.