慢性心力衰竭患者心室复极动态离散度的变化及意义  

The alterations and significance of cardiac repolarization dynamic variability in patients with chronic heart failure

作　　者：黄婷[1] 陈刚[1] 杨锴[1] 

机构地区：[1]武汉市中心医院心血管内科,430014

出　　处：《疑难病杂志》2014年第2期111-113,共3页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的研究慢性心力衰竭患者心室复极动态离散度的变化,并探讨其临床意义。方法选取慢性心力衰竭患者60例(心力衰竭组)和对照人群60例(健康对照组),进行12导联体表心电图和心脏超声检查,评价心功能,并计算QT离散度(QTd)、QT变异指数(QTVI)、QT短期离散度(STVQT);比较2组间上述指标的差异。结果 2组患者QT和QTc〔(369.7±42.1)ms vs.(363.0±38.4)ms,(386.0±17.1)ms vs.(377.8±28.9)ms]比较,差异无统计学意义(P>0.05);心力衰竭组QTd(60.4±10.3)ms、QTVI(-0.4±0.1)、STVQT(5.2±1.3)ms均大于健康对照组(50.7±12.1)ms、(-1±0±0.2)ms、(3.3±1.0)ms,差异有统计学意义(P均<0.01)。心脏超声显示,心力衰竭组患者收缩和舒张功能均差于健康对照组[LVEF:(43.76±3.01)%vs.(58.33±4.84)%;E:(85.05±17.18)cm/s vs.(94.12±16.06)cm/s;E/A:(1.04±0.06 vs.1.23±0.13),差异均有统计学意义(P<0.01)。结论慢性心力衰竭患者的心室复极动态离散度显著增加,提示心脏电活动适应能力下降,可能是患者室性心律失常和心脏性猝死的重要原因。Objective To investigate the dynamic changes of cardiac repolarization variability in patients with chronic heart failure,and to assess its clinic significance.Methods Selected 60 patients with chronic heart failure（CHF group） and60 cases of control subjects（healthy controls）,a 12-lead surface ECG and echocardiography were performed,cardiac function,and calculate the QT dispersion（QTd）,QT variability index（QTVI）,QT dispersion short-term（STVQT） were assessed;differences in these indicators compared between the two groups.Results 2 groups of patients QT and QTc[（369.7±42.1） ms vs.（363.0±38.4） ms,（386.0±17.1） ms vs.（377.8±28.9） ms[were compared,the difference wa-not statistically significant（P 0.05）;heart failure group QTd（60.4 ＋ 10.3） ms,QTVI（-0.4±0.1）,STVQT（5.2±1.3） ms were higher than the healthy control group（50.7±12.1） ms,（-1.0±0.2） ms,（3.3±1.0） ms,the difference was statistically significant（P 0.01）.Echocardiography showed that systolic and diastolic function in patients with heart failure group were worse than healthy controls[LVEF：（43.76±3.01）%vs.（58.33±4.84）%;E：（85.05±17.18）cm/s vs.（94.12±16.06）cm/s;E/A：（1.04±0.06 vs.1.23±0.13）],the differences were statistically significant（P 0.01）.Conclusion The dispersion of repolarization significantly increased in patients with chronic heart failure,which are probably important risk factors for ventricular arrhythmias and sudden death.

关 键 词：心力衰竭 慢性 复极动态离散度 心脏性猝死 

分 类 号：R541.6[医药卫生—心血管疾病]