QTcd

摘要： 目的 探讨环磷腺苷葡胺联合缬沙坦治疗室性心律失常患者的临床疗效,分析对Q-T间期离散度(QTcd)及心率变异性变化的影响.方法 选择2017年12月～2019年12月于我院诊治的室性心律失常患者60例,随机分为对照组和观察组各30例.对照组采用缬沙坦治疗,观察组在对照组基础上加用环磷腺苷葡胺治疗,对比两组QTcd、心率变异性[全程NN间期的标准差(SDANN)、全程每5分钟NN间期平均值的标准差(SDNN)、全部相邻NN之差的均方根(RMSSD)、相邻NN之差>50ms的个数占总窦性心博个数的百分比(PNN50)].结果 治疗3个月后,观察组QTcd低于对照组,差异有统计学意义(P<0.05);治疗3个月后,观察组SDANN、SDNN、RMSSD、PNN50水平均高于对照组,差异均有统计学意义(P<0.05).结论 环磷腺苷葡胺联合缬沙坦对室性心律失常,可减小QTcd,改善心率变异性.

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 探讨急性脑血管病(ACVD)早期心电图QTcd参数与神经功能缺损(NIHSS)评分的相关性.方法 回顾性分析2016年7月～2017年6月东南大学附属盐城医院神经内科收治的发病1～12 h内中风患者98例,按照NIHSS评分分组,NIHSS评分＜7分为轻度(32例);7分≤NIHSS评分＜15分为中度(39例),NIHSS评分≥15分为重度(27例),采用单因素方差分析、x2检验及多元线性回归法比较三组心电图QTcd参数差异及其与NIHSS评分相关性.结果 NIHSS评分重度患者QTcd参数较轻、中度患者差异有统计学意义(P＜0.05),中度患者与轻度患者差异无统计学意义(P＞ 0.05),QTcd与NIHSS评分呈正相关(R=0.467,P＜0.05).结论 ACVD早期心电图QTcd参数可为预测ACVD病情危重程度提供参考依据.%Objective To explore the relationship between electrcardiogram QTcd with NIHSS score in patients with acute cerebrovascular diseases.Methods The data of 98 inpatients within 1-12 h after stroke from July 2016 to June 2017 in Department of Neurology of Eastnorth University Affliated Yancheng Hospital were analyzed retrospectively.They were derided into three groups according to NIHSS score:NIHSS score ＜7 scores was mild (32 cases),7 scores≤ NIHSS score ＜15 scores was moderate (39 cases),NIHSS score≥ 15 scores was severe (27 cases),electrcardiogram QTcd in three groups was compared and analyzed by univariate analysis,x2 test,multivariate linear regression.Results QTcd parameter of severe patients was compared with mild patients and moderate patients,the differences were statistically significant (P ＜ 0.05),those of mild patients and moderate patients were comared,the differences were not statistically significant (P ＞ 0.05),QTcd was positively correlated with NIHSS score (R =0.467,P ＜ 0.05).Conclusion Electrocardiogram QTcd is a better indicator to determine the severity in early patients with acute cerebrovascular diseases.

摘要： 目的 探究与分析肥厚型心肌病患者QTcd、QTd与恶性心律失常及预后的相关性.方法 选取我院收治的98例肥厚型心肌病患者作为观察组,另选择同时期收治的84例无心血管疾病者作为对照组,根据梗阻分型将观察组分为梗阻组(n=20)与非梗阻组(n=78),根据心律失常的类型分为恶性心律失常组(n=35)与非恶性心律失常组(n=63),根据是否死亡分为死亡组(n=9)与存活组(n=89),对比各组之间QTd与QTcd.结果 观察组与对照组相比QTcd、QTd值较高,差异具有统计学意义(P<0.05).恶性心律失常组与非恶性心律失常组相比QTcd、QTd值较高,差异具有统计学意义(P<0.05).死亡组与存活组相比QTcd、QTd值较高,差异具有统计学意义(P<0.05).结论 QTcd、QTd增大对于预测肥厚型心肌病患者恶性心律失常的发生及预后具有一定的应用价值.

摘要： 目的 探讨艾司洛尔对服用ACEI类药物高血压患者麻醉诱导期血流动力学及QT间期和QTD的影响.方法 选择ASAI～Ⅱ级有器质性高血压且规律服用ACEI类药物拟行择期手术患者60例,采用随机数字表法分为艾司洛尔组(E组)和对照组(C组),各30例.E组给艾司洛尔负荷量500Ug/kg,然后以100μg/(kg·min)输注,诱导后4min停止输注.C组输注同样剂量的0.9％氯化钠溶液.艾司洛尔或0.9％氯化钠溶液输注5min后,给2 mg/kg丙泊酚、1μg/kg芬太尼、1mg/kg维库溴铵3min内完成气管插管.记录患者麻醉诱导前(T0)、艾司洛尔或0.9％氯化钠溶液输注后5min(T1)、诱导用药后3min(T2)、插管后30s(T3)、2min(T4)及4min(Ts)的平均动脉压(MBP)、心率(HR)、QTc、QTcD;并观察患者的不良反应.结果 两组患者T0时MBP、HR、QTc、QTcD比较差异无统计学意义(P＞0 05).与C组比较,E组在T1～T3 MBP均降低,E组T1～T5各时点的MBP及C组T2～T5各时点的MBP较T0时MBP均明显降低,差异均有统计学意义(均P＜0.05).两组在T3HR变化相比较差异有统计学意义(P＜0.05).E组除T3外,其余各时点HR均较T0降低,C组在T2时HR较T0减慢,而在T3较T0增快,差异均有统计学意义(均P＜0.05).与C组比较,E组T3时QTc、QTcD明显缩短,差异有统计学意义(P＜0.05).E组T1～T5各时点QTc间期、QTcD与T0时比较差异均无统计学意义(均P＞0.05).C组T3、T4 QTc、较T0、T1均延长,C组T2、T3、T4 QTcD较T0均延长,差异均有统计学意义(均P＜0.05).C组插管后4min心律失常发生率相对较高,差异有统计学意义(p＜0 05).两组均无恶心、呕吐、咳嗽、尿潴留等不良反应.结论 对服用ACEI类药物的高血压患者,艾司洛尔可以抑制麻醉诱导时血流动力学指标波动并缩短延长的QTc及QTcD.

摘要： 目的 探讨莫西沙星对充血性心力衰竭合并社区获得性肺炎(CAP)患者QT间期及QT离散度的影响.方法 将沈阳市胸科医院心血管科2009-2012年收治的116例充血性心功能衰竭(NYHAⅢ-Ⅳ级)合并CAP患者作为观察组应用常规剂量莫西沙星(400mg每日)治疗,116例心功能正常CAP患者作为对照组1应用常规剂量莫西沙星治疗,将116例充血性心功能衰竭(NYHAⅢ-Ⅳ级)合并CAP患者作为对照组2应用常规剂量β-内酰胺类或头孢类抗生素治疗,分析和比较观察组及对照组治疗前后QTc(校正的QT间期)及QTcd(校正的QT间期离散度).结果 使用常规剂量莫西沙星治疗可使单纯CAP患者QTc延长(15.5±6.1)ms,使充血性心力衰竭合并CAP患者QTc延长(48.2 ±5.3)ms;而应用β-内酰胺类或头孢类抗生素的心衰合并CAP患者,治疗前后QTc比较差异无统计学意义;单纯CAP和CAP合并心衰患者使用常规剂量莫西沙星治疗前后QTcd比较,差异也有统计学意义.结论 莫西沙星对心衰合并CAP患者QT间期影响高于单纯CAP而心功能正常者,影响心衰患者QTcd的因素为心衰本身.心衰合并CAP患者应用莫西沙星更应慎重,应在严密监测心电图的基础上应用.

摘要： 目的 探讨预测急性有机磷中毒(AOPP)并发心律失常的有效指标.方法 对2007年7月至2010年6月286例AOPP口服中毒患者进行分析,据心电图结果 将患者分为心律失常组和非心律失常组,比较两组间校正QT离散度(QTcd)、心肌酶谱、肌钙蛋白I(cTnI)以及染毒24 h胆碱酯酶(AchE)的差异.结果 心律失常组患者QTcd异常率、TnI和肌酸激酶同工酶(CK-MB)阳性率显著高于非心律失常组,而AchE显著低于非心律失常组.结论 TnI和CK-MB是监测心肌损伤、预测心律失常的良好指标,实时监测AOPP患者QTcd,对防治其恶性心律失常的发生具有重要意义.

摘要： 目的 探讨冠心病患者心绞痛,心脏性猝死(SCD)与心率变异性(HRV)、窦性心率振荡(HRT)、QT离散度(QTcd)、心室晚电位(VLP)的相关性,给于极化液,美托洛尔治疗,观察其对自主神经功能失衡与SCD的疗效.方法 选择冠心病患者300例,行24 h动态心电图检查,测定心率变异性(HRV),窦性心率振荡(HRT)参数,振荡起始(TO)和振荡斜率(TS),心电图测量校正QT离散度(QTcd),多信息心电检测心室晚电位(VLP),超声心动图检测左心室射血分数(LVEF).对HRT与HRV、LVEF、QTcd、VLP等进行比较分析及治疗前后对照研究.结果 ①冠心病心绞痛患者HRV指标昼夜变化比较,对照组HRV表现出昼夜节律性变化,夜晚较白昼夜高,觉醒前达峰值,醒后迅速下降.冠心病心绞痛患者HRV昼夜规律被破坏,表现为昼夜变化消失.以冠心病组(UA)145例更为明显(p<0.01).②发生SCD 21例,HRV分析值均明显下降(p<0.01),HRT减低、QTcd延长、VLP阳性率增高(p<0.01),同时心率明显增快(p<0.01).③GIK联合美托洛尔治疗后心率变异频域指标明显改善,p<0.01.治疗组不稳定性心绞痛、室性心律失常、心脏性死亡及心力衰竭的发生率较对照组减少(p<0.01).结论 冠心病不稳定性心绞痛患者存在自主神经功能紊乱,是发生SCD的高危人群,HRV、HRT、QTcd、VLP是的对冠心病患者进行危险度分层及病死率的预测的良好指标.极化液、美托洛尔能阻断交感活性对心脏的不良作用,纠正冠心病患者的自主神经失衡,有效地改善心功能,降低病死率,从而减少心律失常及猝死的发生.

摘要： 目的:分析心电图QTcd与急性心肌梗死早期预后的相关性.方法:测定116例急性心肌梗死患者校正的QT间期离散度(QTcd),按照QTcd数值分为两组:QTcd≥60 ms组,QTcd < 60 ms组.比较两组患者的室性心律失常发生率及30 d死亡率.结果:急性心肌梗死患者QTcd≥60 ms组患者中室性心律失常的发生率及30 d死亡率均高于QTcd≥60 ms组.结论:急性心肌梗死QTcd≥60 ms发生室性心律失常的机会较大,且与急性心肌梗死30 d死亡率相关.