继发性短QT综合征相关危险因素及其对生存的影响

Risk factors associated with secondary short QT syndrome and their impact on survival

目的:探索继发性短QT综合征(short QT syndrome, SQTS)的相关危险因素及其对生存的影响。方法:采用Cox回归及生存曲线法分析继发性SQTS的危险因素及其对预后的影响。结果:继发性SQTS患者血清Ca^(2+)、pH值降低;肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、天冬氨酸转氨酶(AST)、高敏肌钙蛋白T(hs-TnT)、尿素氮(BUN)、肌酐(Scr)升高(P<0.05)。血清Ca^(2+)、pH、hs-TnT预测继发性SQTS的AUC在0.7以上,是继发性SQTS的有用预测因子。继发性SQTS患者的中位生存期为590 min, 12 h生存率40%,24 h生存率17%。高龄、呼吸衰竭为继发性SQTS患者预后不良因素。高龄、呼吸衰竭以及CK、AST升高为继发性SQTS的独立危险因素。结论:血清Ca^(2+)、pH、 hs-TnT为继发性SQTS的预测因子;高龄、呼吸衰竭以及CK、AST升高影响继发性SQTS的发生与结局。

Objective: To explore the related risk factors of secondary short QT syndrome(SQTS)and its impact on survival. Methods: Cox regression and survival curve were used to analyze the risk factors of secondary SQTS and its impact on prognosis. Results: Serum Ca^(2+)and pH decreased in patients with secondary SQTS;creatine kinase(CK), creatine kinase isozyme(CK-MB), aspartate aminotransferase(AST), high-sensitivity troponin hs-TnT, urea nitrogen(BUN)and creatinine(Scr)increased(P< 0.05). The AUC of serum Ca^(2+), pH and hs TnT in predicting secondary SQTS is more than 0.7, which is a useful predictor of secondary SQTS. The median survival time of patients with secondary SQTS was 590 min, the 12 h survival rate was 40%, and the 24 h survival rate was 17%. Old age and respiratory failure were the poor prognostic factors in patients with secondary SQTS. Old age, respiratory failure and elevated CK and AST were independent risk factors for secondary SQTS. Conclusion: Serum Ca^(2+), pH and hs-TnT are the predictors of secondary SQTS;Old age, respiratory failure and the increase of CK and AST affect the occurrence and outcome of secondary SQTS. Conclusion: Serum Ca^(2+), pH and hs-TnT are the predictors of secondary SQTS;Old age, respiratory failure and the increase of CK and AST affect the occurrence and outcome of secondary SQTS.