肝硬变患者QT间期延长及QT间期离散度的临床意义

The significance of prolonged QT interval and QT dispersion in patients with liver cirrhosis

目的探讨肝硬变患者QT间期及QT间期离散度 (QTd)的变化与临床意义。方法测量 13 8例病毒性肝炎肝硬变患者的同步 12导联心电图 ,分析QT间期及QTd ,并与其他消化系疾病的 5 0例住院患者进行对照。结果肝硬变患者中QT间期延长发生率非常显著高于对照组 (P <0 .0 1) ,QTd也显著高于对照组 (P <0 .0 5 ) ;肝硬变患者Child PughA、B、C3级中QT间期延长发生率逐步升高 ,QTd增加也逐渐明显 (均为P <0 .0 5 ) ;肝硬变患者中死亡者的QT间期非常显著长于存活者 ,QTd也非常显著增加 (均为P <0 .0 1)。结论肝硬变患者QT间期延长发生率高 ,QTd增加明显 ,且与肝硬变严重程度相平行。提示QT间期延长及QTd可以作为肝硬变严重程度的指标之一。

Objective To evaluate the change and the clinical significance of QT interval and QT dispersion(QTd)in patients with liver cirrhosis.Methods QT interval and QTd on simultaneous recording 12 lead ECG in 138 cases of liver cirrhosis were measured,and compared with 50 cases of the other digestive diseases.Results The rate of prolonged QT interval in cirrhosis group was remarkably higher than that in control group(P<0.01)and the rate of QTd in cirrhosis group was higher,too (P<0.05) .In the cirrhosis patients of Child Pugh A,B,and C grade,the rates of prolonged QT interval were gradually higher and QTd was gradually obvious(P<0.05).In the cirrhosis death cases QT interval were remarkably longer than that in the survival group and QTd were obviously increased(P<0.01).Conclusion The changes of QT interval and QTd are valuable in cirrhosis patients and are correlated with severe level of cirrhosis.The increase of QT interval and QTd can be indexes for severe level of cirrhosis.