原发性肝癌患者异常心电图与转氨酶和电解质的关系探讨  

Changes of electrocardiogram in patients with primary hepatic carcinoma and its related factors

作　　者：朱晨[1] 厉剑[1] 谢玮[1] 张磊[1] 李洪[1] 李骁睿 金莎莎[1] 杨洁[3] 

机构地区：[1]浙江省杭州市第一人民医院心电功能科,310006 [2]浙江科学技术出版社 [3]浙江省杭州市第一人民医院病案统计室,310006

出　　处：《心电与循环》2015年第4期262-264,共3页Journal of Electrocardiology and Circulation

基　　金：浙江省医药卫生科技计划项目(2012KYB155)

摘　　要：目的探讨原发性肝癌患者心电图与年龄、性别、转氨酶和电解质的相关性。方法选择1997年1月至2014年1月经住院确诊的原发性肝癌患者335例,采用x^2检验和多因素logistic回归筛选影响因素的方法,分析心电图表现与年龄、性别、γ-谷氨酰基转移酶(GGT),门冬氨酸氨基转移酶(AST),丙氨酸氨基转移酶(ALT),碱性磷酸酶(ALP)和电解质(血钾、血钙)等指标之间的关系。结果 335例原发性肝癌患者中心电图正常69例(20.60%),心电图异常266例(79.40%),主要异常表现为ST-T和(或)U波改变、心律失常、ST段和(或)Q-T间期延长等;335例原发性肝癌患者中≥60岁患者心电图异常率高于<60岁的患者,GGT升高的患者心电图异常显著高于GGT正常的患者,电解质异常的患者心电图异常显著高于电解质正常的患者,差异均有统计学意义(x^2=11.997、8.324、12.074,均P<0.05);年龄≥60岁、GGT升高、电解质异常是导致患者心电图异常的独立影响因素(P<0.05或0.01)。结论原发性肝癌患者心电图异常与年龄、以GGT升高为主的转氨酶升高和电解质异常有关。Objective To investigate the changes of electrocardiogram （ECG }in patients with primary hepatic carcinoma and its related factors. Methods The clinical data of 335 patients with primary hepatic carcinoma admitted from January 1997 to January 2014 were retrospectively reviewed. The association of ECG changes with serum γ glutamyl transferase （GGT）, aspartate aminotransferase （AST）, alanine aminotransferase （ALT）, alkaline phosphatase （ALP）, potassium, and calcium levels were analyzed. Results Among 335 patients, 69 cases had normal ECG （20.60% ）and 266 had abnormal ECG findings （79.40% ）. The abnormities in ECG were mainly ST-T segment change and/or U wave change, arrhythmia, prolongation of ST segment and/or Q-T interval. The abnormity rate of ECG in patients ~〉60 y was significantly higher than that in patients 〈60y （χ2=11.997,P〈0.05）. The abnormity rate of ECG in patients with high level of serum GGT and abnormal serum electrolyte was higher than that in patients with normal GGT （ χ2=8.324,P〈 0.05 ）or that in patient with normal electrolyte （χ2=12.074, P〈0.05）. The multivariate Logistic regression showed that age ≥60y, elevated GGT, and serum electrolyte abnormality were independent risk factors of abnormal ECG findings. Conclusion The ECG abnormalities are related to older age, elevation of GGT and serum electrolyte abnormality.

关 键 词：原发性肝癌 心电图 转氨酶 电解质 

分 类 号：R735.7[医药卫生—肿瘤]