不同血钙水平对心电图影响分析

Analysis about the influence of different blood calcium levels on electrocardiogram

目的观察不同血清钙离子浓度水平对患者心电图的影响。方法选取新疆医科大学第一附属医院2006年1月至2018年12月诊治的低钙血症患者52例,高钙血症患者50例,年龄与性别匹配的正常血钙患者53例,共155例患者纳入本研究。根据血钙水平分为三组,低钙血症组(血清钙离子水平<2.25mmol/L),血钙正常组(血清钙离子水平2.25~2.75mmol/L),高钙血症组(血清钙离子水平> 2.75mmol/L),比较三组间心电图异常情况,探讨不同血清钙离子浓度水平对心电图影响。结果低钙血症组心律失常发生率11.5%,高钙血症组心律失常发生率为26%,正常血钙组心律失常发生率9.4%,差异有统计学意义(P <0.05);低钙血症组心电图ST改变8%,高钙血症组心电图ST改变12%,正常血钙组心电图ST改变0%,差异有统计学意义(P <0.05);低钙血症组QTc均数440±49ms,高钙血症组QTc均数为380±31ms,血钙正常组QTc均数404±32ms,差异有统计学意义(P <0.05);Pearson相关分析发现患者血钙水平与QTc间期呈明显负相关(r=-0.588,P=0.000),使用多重线性回归模型示血钙水平与QTc呈线性相关,且在校正年龄,心率,血钾,这种相关系仍然存在。结论低钙血症组和高钙血症组心律失常发生率较对照组高,低钙血症组和高钙血症组心电图ST改变较对照组高。Pearson相关分析发现:血钙水平同QTc间期呈负相关,建立多重线性回归示:血钙水平与QTc呈负相关。

Objective To observe the effect of different serum calcium concentration on electrocardiogram(ECG). Methods 52 patients with hypocalcemia, 50 patients with hypercalcemia and 53 patients with normal blood calcium and the same age and the same sex who were hospitalized at the first affiliated Hospital of Xinjiang Medical University from January 2006 to December 2018 were chosen as subjects. A total of 155 patients were included in this study. According to the blood calcium level, all cases were divided into three groups:hypocalcemia group(serum calcium ion level < 2.25 mmol/L), normal blood calcium group(serum calcium ion level 2.25~2.75 mmol/L),hypercalcemia group(serum Calcium ion level > 2.75 mmol/L). The abnormal electrocardiogram between three groups was compared, and the effect of different serum calcium ion levels on ECG was studied. Results The incidence of arrhythmia in hypocalcemia group,hypercalcemia group and normal blood calcium group was 11.5%, 26% and 9.4% respectively. The difference was statistically significant(P < 0.05);The change of ECG ST in hypocalcemia group, hypercalcemia group and normal blood calcium group was 8%, 12%, and 0%respectively, and the difference was statistically significant(P < 0.05);The mean QTc of hypocalcemia group is 440 ±49 ms, that of hypercalcemia group is 380±31 ms, and that of normal blood calcium group is 404±32 ms, the difference was statistically significant(P <0.05). Pearson correlation analysis showed that there was a significant negative correlation between serum calcium level and QTc interval(r =-0.588, P = 0.000). Multiple linear regression model showed that blood calcium level was linearly correlated with QTc, and this relationship still existed at corrected age, heart rate and blood potassium. Conclusion The incidence of arrhythmia in hypocalcemia group and hypercalcemia group is higher than that in control group. The changes of electrocardiogram ST in hypocalcemia group and hypercalcemia group are higher than those in control group. Pearson correlation analysis shows that blood calcium level is negatively correlated with QTc interval, and multiple linear regression shows that blood calcium level is negatively correlated with QTc.