特发性长QT综合征QT离散度的临床意义  

Clinical implication of QT dispersion in idiopathic long QT syndrome

作　　者：赵芙[1] 张相尧[2] 

机构地区：[1]广州市第一人民医院内科,510180 [2]北京空军总医院航空病研究中心

出　　处：《中华心律失常学杂志》2000年第3期191-193,共3页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的　探讨 QT离散度与特发性长 QT综合征 (Idiopathic long QT syndrom e,L QT1)发生尖端扭转性室性心动过速的关系。　方法　 78例基因 (11p15 .5 )携带者根据晕厥发作的频度和程度分 3组 :轻度 (0～ 4次 ,n=5 9) ,中度 (5～ 10 0次 ,n=14)和重度 (有心脏骤停史 ,n=5 )。比较　 13组首次心电图 QT离散度的差异 ;2 18例小于 2 0岁的中、重度患者长期用β阻滞剂后 QT离散度的变化 ;3 9例患者用β阻滞剂前后踏车试验 QT离散度的变化。　结果　 13组间 QT离散度差异显著 (P<0 .0 1) ;2 9/12例长期用β阻滞剂后 ,QT离散度缩小 (P<0 .0 5 ) ;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　 1QT离散度是估计病情的敏感而可靠的指标 ;2小于 2 0岁的中、重度 L QT1(包括“无症状”者 ) 。Objective To investigate the relationship between QT dispersion and TDP in LQT1.Methods 78 gene carriers (11p15 5) were divided into 3 groups,depending on the severity of syncope occured during many years:the mild (0～4 episodes, n =59),the moderate (5～100, n =14) and the severe ( n =5 with cardiac arrest).To compare①the differences of QT dispersion among 3 groups;②QT dispersion changes after chronic betablocker (BB) therapy in 12 moderate to severe cases;③QT dispersion changes during exercise test in 9 cases before and after BB. Results ①QT dispersion is significantly different among 3 groups ( P <0 01);②After chronic BB therapy,QT dispersion decreased in 9/12 cases ( P <0 05);③During exercise test,in LQT1,QT dispersion positively correlated with load before betablocker treatnent.On the contrary,it negatively correlated,after betablocker treatnent ( P <0 01). Conclusions ①QT dispersion is a sensitive and reliable marker to predict TDP;②Betablocker should be taken in the moderate to severe cases under 20 yrs,especially in those asymptomatic at risk of TDP.

关 键 词：特发性长QT综合征 QT离散度 心动过速 TDP 

分 类 号：R541.7[医药卫生—心血管疾病] R540.41[医药卫生—内科学]