慢性肾衰血透患者QT离散度变化与室性心律失常及心绞痛的关系

Relationship between ventricular arrythmias,angina pectoris and changes of QT dispersion in patients with end-stage renal disease undergoing hemodialysis

目的 检测 35例尿毒症患者血液透析前后QT离散度 (QTd)的变化 ,并进一步探讨其与室性心律失常及心绞痛发生的关系。方法 对 35例尿毒症维持性血液透析患者 ,分别采用 12导联同步记录心电图检测尿毒症患者血液透析前、中、后的QTd变化 ,并观察透析对QTd变化和对室性心律失常及心绞痛发生的影响。结果 ①QT间期正常的 2 0例患者透析结束后QTd略有延长 (P >0 .0 5 ) ,无统计学意义 ,无 1例发生心绞痛。②QT间期在透析前已延长的 15例患者 ,透析后明显延长 (P <0 .0 5 ) ,有 2例因室性心律失常与急性心肌梗塞急性期抢救无效死亡 ,9例透析中心绞痛发作 ,发作时与发作后QTd统计学处理有意义 (P <0 .0 5 )。结论 ①QTd延长的血透病人室性心律失常的发生率高。②QTd延长的血透病人在透析中可能发生心绞痛。

Objective To investigate the change of QT dispersion (QTd) in 35 patients with end stage renal disease(ESRD) undergoing hemodialysis and observe the relationship with the occurrence of ventricular arrythmias and angina pectoris.Methods Recorded 12 lead ECG QTd and the effect on ventricular arrythmias and angina pectoris.Results ①There was no significant difference of QTd before and after HD in 20 patients with normal QT interval ( P <0.05).No angina pectoris occurred.②Fifteen patients with longer QT interval before HD had obviously prolonged QT interval after HD ( P <0.05).Two of them died of ventricular arrythmias and AMI.Nine suffered from angina pectoris during HD.There was statistical significance of QTd before and after attack( P <0.05).Conclusion ①Patients with prolonged QTd undergoing HD have higher risk of ventricular arrythmias.②The prolonged QTd can increase the incidence of angina pectoris in patients undergoing HD.③Patients with prolonged QTd undergoing HD have the potential risk of cardiac accidence and sudden death.