QTc

摘要： 背景 睡眠对于维持人体健康至关重要,睡眠质量和睡眠时长与多种疾病发生相关.既往职业人群研究表明,睡眠剥夺与QT间期延长相关.但关于一般人群中睡眠质量、睡眠时长与校正的QT间期(QTc)关联的研究较少.目的 探讨中国老年人群睡眠质量及睡眠时长与QTc的关联.方法 选取2017年11—12月如皋市长寿和衰老队列(RuLAS)的睡眠和心电图数据,并根据匹兹堡睡眠质量指数量表(PSQI)评分将老年人分为睡眠正常组(n=776)、睡眠质量轻度下降组(n=214例)、睡眠质量下降组(n=152例);通过静息心电图(ECG)仪的解读程序收集ECG参数〔QTc、心率(HR)、P波、QRS间期、PR间期、V5导联的R波(RV5)、V1导联的S波(SV1)〕.采用多重线性回归分析探讨PSQI评分与QTc的影响因素.结果 老年人PSQI评分为(4.6±2.6)分,夜间睡眠时长为(9.2±1.8)h.3组间性别、受教育程度、饮酒情况、糖尿病患病情况、认知功能评分、体力活动评分、QTc、RV5比较,差异均有统计学意义(P10 h〔β=8.81,95％CI(0.24,17.39),P=0.044〕的睡眠时长是QTc的影响因素.结论 中国老年人群睡眠质量差、睡眠时长过长或过短与QTc相关,提示睡眠质量及时长可能是QTc的影响因素之一,改善睡眠可能预防QTc延长,从而预防心源性死亡.

摘要： Prolongation of the QT interval is associated with adverse cardiac events specifically Torsades de pointes(TdP).There are multiple mediations that have a known,possible,or conditional risk for prolonged QT interval,but general practitioners’knowledge of these medications is unknown.We conducted a survey to assess internal medicine(IM)providers’knowledge of risk factors and medications associated with prolonged QT as well as provider experience and comfort when treating patients with prolonged QT.A 17-question,anonymous survey was constructed in 2019 and distributed to IM providers and residents at a tertiary care center.Questions included demographic information,6 Likert-scale questions gauging provider experience with prolonged QT,and 10 multiple choice clinical vignettes to assess clinical knowledge.Data was analyzed descriptively.Knowledge was assessed via clinical vignettes and compared by level of training.Forty-one responses were received out of a total of 87 possible respondents(47.1%response rate).About 70%of respondents see patients with acquired prolonged QT once monthly or more.95%rarely see congenital prolonged QT.When presented with QTc drug issues,73%of providers seldom or sometimes consulted pharmacy,but about half used online resources.The average correct score on the clinical vignettes was 5.59/10,with the highest scores seen in attending physicians in their first five years of practice(6.96/10).Our survey suggests that IM providers commonly encounter QT prolonging drugs.Educational efforts to improve knowledge of drug and patient risk factors for TdP may be needed.

摘要： 目的:探究炙甘草汤联合美托洛尔对冠心病室性心律失常患者心率、QTd及QTc间期的影响.方法:选取2016年2月～2018年10月于我院诊治的冠心病室性心律失常患者60例,采用随机数字表法分为对照组和观察组各30例.对照组给予琥珀酸美托洛尔缓释片口服,观察组在对照组治疗基础上联合炙甘草汤治疗.对比两组临床疗效,治疗前后心率、心电图变化及不良反应发生率.结果:观察组治疗总有效率高于对照组,治疗后心率较对照组低,QTd间期较对照组短,QTc间期较对照组长,不良反应发生率低于对照组,差异均有统计学意义(P＜0.05).结论:采用炙甘草汤联合美托洛尔治疗冠心病室性心律失常患者可显著改善患者心率QTd及QTc间期时长,疗效显著.

摘要： 目的 探讨QRS时限、Tp-Tec、QTc在慢性心力衰竭(CHF)患者心电图检查中的应用价值.方法 选取2016年8月至2018年1月我院收治的60例CHF患者为研究对象,根据是否合并室性心律失常将其分为A组(24例,合并室性心律失常)和B组(36例,未合并室性心律失常),另选取同期入院体检的健康人员30名作为C组.所选对象均在入院后接受心电图检查,比较三组受检者入院时的QRS时限、Tp-Tec、QTc等心电图参数水平;A、B组患者均接受3个月治疗,比较A、B组患者治疗后的QRS时限、Tp-Tec、QTC减少值及疗效.结果 A、B组患者的QRS时限、Tp-Tec、QTc均显著长于C组,差异均具有统计学意义(P<0.05);A组患者的QRS时限、Tp-Tec均显著长于B组,差异均具有统计学意义(P<0.05).治疗后,A组患者的QRS时限、Tp-Tec、QTc减少值均显著大于B组,差异均具有统计学意义(P<0.05);A组患者的治疗总有效率显著高于B组,差异具有统计学意义(P<0.05).结论 心电图检查中的QRS时限、Tp-Tec、QTc等参数水平可提示CHF的发生情况和病情严重程度,而上述参数的变化情况也能为临床疗效的评价和预测提供一定的参考依据,值得临床借鉴.

摘要： Background: In pseudoexfoliative syndrome (PEX), extraocular accumulation is associated with cardiovascular morbidity and mortality. The aim of this study was to investigate the effect of exercise test on corrected QT dispersion (QTcd) and QTcd recovery in PEX. Patients and Methods: A total of 37 patients diagnosed as PEX were included in the study. The control group consisted of 38 patients. The Electrocardiographies (ECG) were taken. The patients were subjected to an exercise test. Results: In the study group, baseline, peak and third minute recovery QTcd values were 41.35 ± 7.27 ms, 65.19 ± 7.83 ms, and 53.61 ± 6.45 ms, respectively. In the control group, baseline, peak and third minute recovery QTcd values were 29.92 ± 4.23 ms, 38.31 ± 4.22 ms and 28.76 ± 3.09 ms, respectively. There was statistically significant?difference between the baseline and peak QTcd values of the study group and?the control group (t = 8.34224/p 0.00001, t = 18.55079/p 0.00001, respectively). In addition, while there was a statistically significant?difference between the baseline QTcd and the third minute recovery QTcd in the study group, there was no statistically significant difference between the baseline QTcd value and the third minute recovery QTcd value in the control group as heart rate recovery (t = 8.388558/p 0.00001, t = 1.967315/p = 0.056668, respectively).?Conclusion: All of them were found to have a higher risk in terms of malignant ventricular arrhythmia in the study group, both at rest and with effort, in a statistically significant way compared to the control group.

摘要： 目的:观察老年冠心病或有冠心病风险患者行腹部手术时低浓度地氟烷复合瑞芬太尼对其校正的QT间期(QTc)的影响.方法:选择择期在全身麻醉下行腹部手术患者58例,年龄65~85岁,有冠心病史或两个以上危险因素,手术时间>1 h.随机分为3组:试验1组(0.8MAC地氟烷处理,n=20)、试验2组(0.6MAC地氟烷处理, n=19)、对照组(n=19);3组麻醉诱导方法相同,术中维持应用丙泊酚、瑞芬太尼和顺式阿曲库按,试验组分别调整地氟烷浓度,1组为0.8 MAC地氟烷、2组为0.6 MAC地氟烷,对照组不用地氟烷.观察并记录诱导前(T0)、插管后(T1)、手术开始前(T2)、手术开始1 h(T3)、拔管即刻(T4)及术后1 h(T5)各时间点QTc、平均动脉压(MAP)、脑电双频指数(BIS)及心率,记录围术期心电图的各种变化包括ST-T改变、心律失常等情况;记录各组血管活性药物的使用次数.结果:与对照组比较,在T3时间点,试验1组QTc值延长,MAP降低(P0.05).结论:0.6 MAC~0.8 MAC的呼气末地氟烷浓度复合瑞芬太尼可较安全地应用于老年冠心病或有冠心病风险患者,能维持稳定的血流动力学状态.%Objective:To observe the effect of low concentration of desflurane combined with remifen-tanil on the corrected QT interval(QTc) during abdominal surgery in elderly patients with coronary artery disease CAD or high CAD risk. Methods:A total of fifty-eight patients aged 65-85 years with a history of CAD or a high CAD risk were prospectively studied. The patients were scheduled to undergo laparoto-my under general anesthesia with an expected duration longer than 1 h. The patients were randomly dev-ided into three groups,experiment group 1(n=20) and experiment group 2(n=19) inhaled 0.8 mini-mal alveolar concentration(MAC) and 0.6 MAC desflurane respectively,control group(n=19) inhaled no desflurane. The anesthesia induction of the three groups were the same. The QTc,mean arterial pres-sure(MAP),heart rate(HR), bispectral index(BIS), the electrocardiographic changes and the use of vasoactive agents were recorded before(T0) and after the intubation(T1),before(T2) and 1 h after(T3) the start of the operation,extubation(T4) and 1 h after the operation(T5). Results:Compared with the control group,at T3,the QTc was prolonged,MAP was decreased in experiment group 1(P0.05). Conclusion:The anesthesia protocols of 0.6-0.8 MAC of end tidal desflurane concentration combined with remifentanil might be safely applied to elderly patients with CAD or high CAD risk and maintain stable hemodynamic state.

摘要： 目的 研究QT、QTc与代谢综合征(MS)的相关性.方法 纳入2011年4月至2013年4月期间参与沈阳市城区动脉硬化及其相关疾病研究的居民,对其进行问卷调查、体格检查、实验室检查和心电图检查,依据国际糖尿病联盟(IDF)诊断标准将其分为MS组及非代谢综合征(NMS)组.QT间期由12导联心电图测得,QTc按照Bazett和Fridericia公式计算,分析QT及QTc与MS及其组分的相关性.结果 共纳入739名35~64周岁居民,MS组与NMS组比较,QTcB及QTcF明显延长[(415.8±31.9)ms vs.(410.1±32.1)ms,(407.2±29.1)ms vs.(402.6±28.8)ms,P<0.05].随着MS组成因素增多,QT、QTcB及QTcF呈延长趋势.回归分析显示QT间期与血钾、吸烟、血糖、低密度脂蛋白相关,QTcB及QTcF与患高血压病、腰围、血钾相关.结论 MS者QTc易出现延长,可能使MS患者恶性心律失常及猝死的发生风险增加,需重视对其进行心电图的检测,有助于心血管疾病的早期防治.%Objective To investigate correlation between QT interval(QT),corrected QT interval(QTc) and metabolic syndrome(MS). Methods Residents who participated in our survey concerning atherosclerosis and related diseases conducted in Shenyang were included. They accomplished questionnaire,physical examination, laboratory tests and electrocardiography test. We divided them into MS group and non-metabolic syndrome (NMS)group according to International Diabetes Federation(IDF)diagnostic criteria for MS. QT interval was measured from the standard 12-lead electrocardiogram. QTc was calculated by using Bazett and Fridericia equations. We analyze correlation of QT ,QTc and MS. Results A total of 739 residents who were 35~64 years old were included. Individuals with MS had longer QTcB and QTcF than NMS group[(415.8 ± 31.9)ms vs.(410.1 ± 32.1)ms, (407.2± 29.1)ms vs.(402.6 ± 28.8)ms,P<0.05]. The more the number of abnormal MS parameters they had, the longer the QT,QTcB and QTcF they had. Regression analysis showed that QT was associated with serum potassium,smoking,blood glucose,and LDL,and QTcB and QTcF were associated with hypertension,waist circumference and blood potassium. Conclusions MS is associated with corrected QTc. Careful ECG monitoring among persons with MS for early detection of a long corrected QT interval may prevent severe and often fatal arrhythmias or sudden death.

摘要： 目的 观察收缩性心衰患者心律失常发生情况并分析各项心电图指标.方法 回顾性分析我院住院的收缩性心衰患者病历资料.选取我院住院的94例左室射血分数(LVEF) ＜50％的心衰患者,根据患者LVEF将患者分为2组:LVEF≤35％组和LVEF＞35％组,并分析患者住院资料,提取12导联心电图心律失常和心电图异常情况、实验室检查等指标.结果 纳入收缩性心衰患者94例,其中LVEF≤35％患者31例.常见的伴随疾病包括高血压(52.1％)、糖尿病(29.8％)、冠脉疾病(25.5％)、扩张型心肌病(23.4％)、慢性肾脏病(12.8％)、卒中(9.5％).心电图分析发现,24.7％的患者有心动过速,23.7％的患者QRS＞120 ms,51.1％的患者矫正QT(QTc)间期延长(男性QTC ＞440 ms,女性＞460 ms).最常见的心律失常为房颤和室早,各占26.8％和25.8％.房颤患者中快室率占32％;好发的心律失常中房早占18.3％、窦性心动过速占16.1％、右束支传导阻滞(RBBB)占7.5％、左束支传导阻滞(LBBB)占5.3％.严重收缩性心衰患者(LVEF≤35％)QRS波时限(P＜0.01)和QTc间期(P=O.008)较LVEF＞35％组明显延长.结论 收缩性心衰患者最常见的心律失常为房颤和室早,并且QRS波时限和QTc间期明显延长.%Objective The purpose of this study is to find common arrhythmias and electrocardiographic changes in patients with systolic heart failure.Methods The electrocardiograms(ECGs) of 94 patients admitted to our hospital who had systolic heart failure with ejection fraction (EF)＜50％ on echocardiogram were collected and retrospective studied.The patients were divided into two groups:one with EF ≤ 35％ and the other with EF＞35％,based on EF.Twelve leads ECG of these patients was reviewed to identify common arrhythmia and demographic variables;laboratory results were compared to identify the differences.Results A total of 94 patients with systolic heart failure,31 had an EF≤35％.Hypertension 52.1％,diabetes 29.8％,coronary artery disease 25.5％,dilated cardiomyopathy 23.4％,chronic kidney disease 12.8％ and stroke 9.5％ are common associated comorbidities.On analysis of EKG,24.7％ had tachycardia,23.7％ had wide QRS＞120 ms,51.1％ had prolonged corrected QT (QTc).The most common arrhythmias were atrial fibrillation and ventricular premature contractions which were found in 26.8％ and 25.8％,respectively.Other common arrthymias were atrial premature contractions 18.3％,sinus tachycardia 16.1％,right bundle branch block 7.5％ left bundle branch block 5.3％.Patients with severe systolic heart failure had prolonged QRS (P＜0.01) and prolonged QTc (P=0.008) as compared to the other group.Conclusion Atrial fibrillation and ventricular premature contractions were common arrhythmias in patients with systolic heart failure.Patients with severe systolic heart failure had statistically significant prolongation of the QRS duration and QTc interval.

摘要： 目的:分析利培酮和草酸艾司西酞普兰联合使用对患者QTc间期的影响程度.方法:选取2017年2-5月来本院门诊或住院治疗的100例精神分裂症患者作为研究对象,随机分为研究组与对照组,每组各50例,研究组患者使用利培酮胶囊和草酸艾司西酞普兰片进行治疗,对照组使用利培酮胶囊进行治疗.比较两组患者治疗前后心电图QTc间期的变化及不良反应.结果:研究组治疗后QTc与治疗前相比有所延长,治疗2、3周后与治疗前相比差异均有统计学意义(P0.05).结论:联合使用利培酮和草酸艾司西酞普兰对精神分裂症患者心电图QTc间期的延长效果较为显著,但心率失常风险增高,临床中医师要特别注意.

摘要： 本实用新型公开了一种实验室用的QTC复合溶剂擦拭布，包括擦拭布主体，所述擦拭布主体的上端设置有手掌固定结构，所述擦拭布主体的内部设置有拇指固定结构，所述拇指固定结构的上端设置有调节拉片，所述拇指固定结构的内部对称设置有两个弹性连接线，所述擦拭布主体的上端开设有安装连接槽，所述擦拭布主体的上端在位于安装连接槽的一侧开设有贯通槽。本实用新型所述的一种实验室用的QTC复合溶剂擦拭布，属于清洁用品领域，通过设置手掌固定结构，可以便于擦拭布拿取的同时也便于手掌的固定；通过设置拇指固定结构和弹性连接线，可以便于拇指的固定，从而最终使得实验室用的QTC复合溶剂擦拭布使用更为方便。