乙型肝炎肝硬化患者心脏病变的研究

A study on heart disease in patients with hepatitis B virus-related cirrhosis

目的观察肝炎肝硬化患者的心电图及超声心动图表现,评价患者的心脏病变情况。方法2019年7月1日至2020年11月30日于首都医科大学附属北京地坛医院住院诊治的乙型肝炎肝硬化患者50例,作为研究组。纳入同时间段住院的乙型肝炎患者共41例,作为对照组。两组患者均接受心电图以及超声心动图检查,比较两组心电指标(HR、P波宽度、PR间期、QRS波宽度、QTc)以及心脏结构(LA、RV、MPA、LVDd、LVDs、AOR、AO)和功能(LVEF、E、A、E/A、PV、AV)等指标的差异。结果研究组的QTc间期为(443.6±26.6)ms,高于对照组(426.1±20.8)ms(t=-3.444,P<0.01);研究组的LA为(35.8±4.3)mm,高于对照组(32.5±4.7)mm(t=-3.509,P<0.01);研究组的PV为(105.9±31.8)cm/s,高于对照组(92.2±18.7)cm/s(t=-2.427,P<0.05);而HR、P波宽度、PR间期、QRS波宽度、RV、MPA、LVDd、LVDs、AOR、AO、LVEF、E、A、E/A、AV等指标两组比较差异无统计学意义(P>0.05)。结论乙型肝炎肝硬化患者可出现心脏电活动以及心脏结构和功能的异常,具体表现为QTc延长,以及LA扩大和PV增快。

Objective To observe the electrocardiograph(ECG)and echocardiographic features of patients,with hepatitis B virus(HBV)-related cirrhosis and to evaluate the heart involvement.Methods A total of 50 patients with HBV-related cirrhosis admitted to our hospital from July 1,2019 to November 30,2020 were enrolled as the study group.A total of 41 hepatitis B patients hospitalized at the same period were selected as the control group.All the subjects underwent ECG and echocardiography,and then the differences of cardiac?electrophysiology[heart rate(HR),P wave,PR interval,QRS wave,QTc],cardiac?structure[left atrium(LA),right ventricular(RV),main pulmonary artery(MPA),left ventricular end diastolic diameter(LVDd),left ventricular end systolic diameter(LVDs),aortic root(AOR),aorta ascendens(AO)]and cardiac?function[left ventricular ejection fraction(LVEF),E,A,E/A,pulmonary blood flow velocity(PV),aortic blood flow velocity(AV)]between the 2 groups were compared.Results The QTc interval of study group was(443.6±26.6)ms,which was significantly higher than that of control group[(426.1±20.8)ms,t=-3.444,P<0.001].The LA of study group was(35.8±4.3)mm,which was significantly higher than that of control group[(32.5±4.7)mm,t=-3.509,P<0.001].The PV of study group was(105.9±31.8)cm/s,which was higher than that of control group[(92.2±18.7)cm/s,t=-2.427,P<0.05].There was no significant difference on other indexes(HR,P wave,PR interval,QRS wave,RV,MPA,LVDd,LVDs,AOR,AO,LVEF,E,A,E/A,AV).Conclusion Abnormality of cardiac electrophysiology,structure and function including prolonged QTc,enlarged LA and increased PV might occur in patients with HBV-related cirrhosis.