目的 研究系统性红斑狼疮(systemic lupus erythematosus,SLE)患者QT间期离散度(QT-interval dispersion,QTd)的变化与心脏损害及病程、疾病活动、抗心磷脂抗体等临床资料的相关性.方法 选取173例SLE患者和70例性别、年龄匹配的健康对照者,回顾性地分析SLE患者的临床资料,测量每份心电图12导联的QT间期计算QTd.结果 (1)SLE患者QTd较健康对照者明显延长(P<0.01),其中有明显心脏损害SLE患者QTd较无明显心脏损害SLE患者和健康对照者明显延长(P<0.01;P<0.01),无明显心脏损害SLE患者QTd较健康对照者明显延长(P<0.01);(2)SLE患者晚期组QTd较早期组和初发组明显延长(P<0.01;P<0.01);(3)SLE重度活动组QTd较轻度活动组和稳定组明显延长(P<0.05;P<0.05);(4)SLE抗心磷脂抗体阳性组QTd较抗心磷脂抗体阴性组明显延长(P<0.05);(5)SLE患者QTd与病程、疾病活动指数(SLEDAI)、抗dsDNA抗体、收缩压、舒张压呈正相关(分别:r=0.176,P<0.05;r=0.178,P<0.05;r=0.172,P<0.05;r=0.393,P<0.01;r=0.355,P<0.01).结论 SLE患者QTd明显延长并与多种心脏损害的危险因素相关.QTd可能是SLE患者心脏损害的一个有用的评价指标.%Objective To investigate the changes of QT-interval dispersion( QTd ) from patients with systemic lupus erythematosis( SLE ) and analyze the relationship between QTd and the clinical characteristics of SLE patients including the cardiac abnormalities , course of disease, disease activity and anticardiolipin antibody( ACA ). Method 173 SLE patients and 70 healthy subjects matching for age and sex served as controls were enrolled in this study. The clinical data of these patients were analyzed retrospectively. QT interval was measured in each lead of standard 12-lead ECGs and the QTd was calculated. Results QTd of SLE patients with overt cardiac involvement were higher than SLE patients without overt cardiac involvement and healthy controls( P<0.01,P<0.01 ), and QTd of SLE patients without overt cardiac involvement were higher than healthy controls( P =0. 000 ). QTd of SLE patients in late group were higher than those in early and incipient group( P <0. 01 ,P <0.01 ). QTd of SLE patients in severe activity group were higher than those in mild activity and inactivity group (P<0. 05,P<0.05 ). QTd of SLE patients with positive ACA were higher than the SLE patients with negative ACA( P < 0. 05 ). QTd were found to be positively correlated with SLEDAI scores, anti-dsDNA, disease duration, systolic blood pressure and diastolic blood pressure ( r=0. 176,P <0. 05;r =0. 178 ,P <0. 05;r =0. 172,P <0. 05 ;r =0. 393 ,P <0. 01 ;r =0. 355 ,P <0.01,respectively ). Conclusion QTd in the SLE patients are increased significantly, and related with some cardiovascular risk factors. QTd could be a useful tool for evaluating the cardiac abnormalities in the SLE patients.
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