儿童短QT间期综合征与恶性心律失常的预后研究  

Effects of Short QT Syndrome and Malignant Arrhythmia on Prognosis in Children

作　　者：黄佐贵[1] 杜国伟[1] 殷波[1] 李倩[1] 金海燕[1] 

机构地区：[1]重庆三峡中心医院心血管科,404000

出　　处：《中华全科医学》2011年第3期364-366,共3页Chinese Journal of General Practice

摘　　要：目的探讨儿童短QT间期综合征(SQTS)与恶性心律失常的预后意义。方法随机测量18例儿童常规12导联心电图(ECG)QTFridercia(QTfc)和QTNomogram(QTnc)间期,根据R-R间期(R-R)和心率(HR)计算QT间期校正值(QTFridercia、QTNomogram)。QTFridercia、QTNomogram间期≤300 ms为短QT间期,观察短QTFridercia、QTNomo-gram间期与恶性心律失常的关系。用奎尼丁、氟卡尼和除颤器(Implanted cardioverter-defibrillator)治疗观察其预后。结果 QTFridercia≤300 ms发生心律失常为100%,QTNomogram≤300 ms发生心律失常为100%;奎尼丁、氟卡尼可使QT间期值平均延长20 ms,减少恶性心律失常发生,P<0.05。单用奎尼丁、氟卡尼治疗2年内心律失常发生率QT Fridercia44.44%,QTNomogram 44.44%;死亡率分别为11.11%、11.11%。除颤器治疗6例SQTS患者在2年的观察中无恶性心律失常发生和死亡率发生,P<0.05。结论短QT间期与恶性心律失常有关;奎尼丁、氟卡尼能延长QT间期,可减少恶性心律失常发生;ICD能有效防止恶性心律失常的发生率和死亡率。Objective To explore the effects of short QT syndrome and malignant arrhythmia on the prognosis in children. Methods The QT Fridercia（ QTfc ）and QT Nomogram（QTnc） were calculated by determining the conventional twelve lead ECG of eighteen children. The relation between the short QT interval（ QT Fridercia and QT Nomogram interval≤300 ms） and the malignant arrhythmia was evaluated. Quinidine, Flecainide and implanted cardioverter-debrillator （ICD） were used to treat the arrhythmia, and the prognosis was observed. Results The rate of arrhythmia were both 100% in cases with QT Fridercia ≤300 ms and QT Nomogram≤300 ms. Quinidine and Flecainide prolonged QT interval average by 20 ms,and decreased the rate of malignant arrhythmia（ P 〈 0.05 ）. The rate of malignant arrhythmia and mortality in patients treated only with Quinidine oreeainide in two years was 44. 44% and 11.11%, respectively; while the rate was 0 in six patients treated with ICD （P 〈 0. 05 ）. Conclusion The short QT interval is related to the malignant arrhythmia in children. Quinidine and Flecainide can prolong the QT interval, and prevent malignant arrhythmia. ICD can effectively decrease the rate of malignant arrhythmia and mortality.

关 键 词：儿童 短QT间期 恶性心律失常 预后 

分 类 号：R541.75[医药卫生—心血管疾病]