特发性长QT综合征QT离散度与尖端扭转性室性心动速的关系  

Relationship between torsades de pointes and QT dispersion in idiopathic long QT syndrome

作　　者：赵芙[1] 

机构地区：[1]广州市第一人民医院心内科,广东广州510080

出　　处：《第一军医大学学报》2005年第10期1312-1313,共2页Journal of First Military Medical University

摘　　要：目的探讨QT离散度与特发性长QT综合征(LQT1)发生尖端扭转性室性心动过速的关系.方法79例基因(11p15.5)携带者根据晕厥发作的频度和程度分为3组:轻度(0～4次,n=59),中度(5～100次,n=14)和重度(有心脏骤停史,n=5).比较:3组首次心电图QT离散度的差异;19例小于35岁的中、重度患者长期用β阻滞剂后QT离散度的变化;9例患者用β阻滞剂前后踏车试验QT离散度的变化.结果(1)3组间QT离散度有显著差异(P＜0.01);(2)13例长期用β阻滞剂者,10例QT离散度缩小(P＜0.05);(3)患者用β阻滞剂前,QT离散度与运动负荷呈正相关,用β阻滞剂后,呈负相关.结论QT离散度是估计病情的敏感而可靠的指标;小于35岁的中、重度LQT1(包括'无症状'者)应长期用β阻滞剂.Objective To investigate the relationship between QT dispersion and torsades de pointes （TDP） in idiopathic long QT syndrome （LQT1）. Methods Seventy-nine carriers of the gene on the chromosome 11pl 5.5 were divided into 3 groups according to the severity and frequency of syncope episodes, namely the mild （0-4 episodes, n=59）, moderate （5-100 episodes, n=14） and severe （with history of cardiac arrest, n=5）. The differences in QT dispersion in the initial ECGs recorded were compared between the 3 groups, and the QT dispersion changes after chronic beta-blocker therapy in 19 moderate to severe cases under 35 years, along with the changes during exercise in 9 cases before and after beta-blocker therapy were evaluated and compared. Results QT dispersion was significantly different between the 3 groups （P〈0.01）, and after chronic beta-blocker therapy, QT dispersion decreased in 10 of the 13 cases （P〈0.05）. During the exercise test, the QT dispersion was positively correlated with the exercise load before beta-blocker treatment but inversely correlated after the treatment （P〈0.01）. Conclusions QT dispersion is a sensitive and reliable marker to predict TDP and beta blocker should be given to moderate or severe LQT 1 cases under 35 years, especially in the asymptomatic cases at risk of TDP.

关 键 词：特发性长QT综合征 QT离散度 室性心动过速 Β阻滞剂 

分 类 号：R541.7[医药卫生—心血管疾病]