美沙拉嗪对炎症性肠病患者心电图特征影响的分析  

Influence of mesalazine on electrocardiographic characteristics in patients with inflammatory bowel disease

作　　者：叶冰洁 刘明鑫[1] 李威 唐艳红[1] Ye Bingjie;Liu Mingxin;Li Wei;Tang Yanhong(Department of Cardiovascular Medicine,Renmin Hospital of Wuhan University,Hubei Province,Wuhan 430061,China;不详)

机构地区：[1]湖北省武汉市武汉大学人民医院心血管内科,武汉430061

出　　处：《中国循证心血管医学杂志》2021年第1期81-84,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨美沙拉嗪治疗对炎症性肠病(IBD)患者心电图特征的影响。方法选取2016年12月至2018年5月于武汉大学人民医院消化内科收治的急性IBD患者为观察组(n=118),给予美沙拉嗪肠溶片0.5 g口服,3/d,连续服药8周;选取同期入院且病程为8周的IBD患者(来院前曾于外院就诊,但未明确诊断且未给予针对性药物干预)为病例对照组(n=27);另选取同期来院体检的健康体检者为健康对照组(n=118)。3组均行标准12导联心电图,比较观察组治疗前后,观察组治疗后与健康对照组,观察组治疗后与病例对照组的白细胞计数(WBC)、C反应蛋白(C-RP)、红细胞沉降率(ESR)、电解质水平、P波离散度和QT间期等指标。结果与观察组治疗前相比,治疗后WBC、C-RP和ESR均明显降低(P<0.05),血钾、血钙和血镁水平均明显升高(P<0.05),P波时限、QTc、P波离散度、QT间期离散度和QTc离散度均无明显差异(P>0.05)。与健康对照组相比,观察组治疗后WBC、C-RP、ESR、血钾、血钙和血镁水平无明显差异(P>0.05),P波时限(min)和QTc明显增大(P<0.05),P波时限(max)、P波离散度、QT间期离散度和QTc离散度明显减小(P<0.05);与病例对照组相比,观察组治疗后WBC、C-RP和ESR明显降低(P<0.05),血钾、血钙和血镁水平明显升高(P<0.05),P波时限(min)、QTc(min)、P波时限(max)、P波离散度、QT间期离散度和QTc离散度均无明显差异(P>0.05)。结论IBD患者有严重心律失常风险,即使在美沙拉嗪治疗后处于缓解期时亦会出现心律失常,应不定期监测心电图。Objective To discuss the influence of mesalazine on electrocardiographic characteristics in patients with inflammatory bowel disease(IBD).Methods IBD patients(n=118)were chosen into observation group(treated with mesalazine in 0.5 g/time,3/d for 8 weeks)from Department of Gastroenterology in Renmin Hospital of Wuhan University from Dec.2016 to May 2018.In the same period,IBD patients(n=27)with 6-week disease course were chosen into case control group(visited doctors in other hospital without definite diagnosis and targeted drug intervention).The healthy controls(n=118)with physical examinations were chosen into healthy control group.All 3 groups were given examination of 12-lead electrocardiography(ECG),and indexes of white blood cell count(WBC),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),electrolyte level,P wave dispersion and QT interval were compared among 3 groups before and after treatment.Results The levels of WBC,C-RP and ESR decreased significantly(P<0.05)and levels of potassium,calcium and magnesium in blood increased significantly(P<0.05),and P wave duration,QTc,P wave dispersion,QT interval dispersion and QTc dispersion had no significant difference(P>0.05)in observation group after treatment than before.WBC,C-RP,ESR and levels of potassium,calcium and magnesium in blood had no significant difference(P>0.05),and P wave duration(min)and QTc increased significantly(P<0.05),and P wave duration(max),P wave dispersion,QT interval dispersion and QTc dispersion decreased significantly(P<0.05)in observation group compared with healthy control group after treatment.WBC,C-RP and ESR decreased significantly(P<0.05),levels of potassium,calcium and magnesium in blood increased significantly(P<0.05),and P wave duration(min),QTc(min),P wave duration(max),P wave dispersion,QT interval dispersion and QTc dispersion had no significant difference(P>0.05)in observation group compared with case control group after treatment.Conclusion IBD patients have risk of severe arrhythmia even in remission stage after

关 键 词：炎症性肠病 P波离散度 QT间期 心律失常 

分 类 号：R540.41[医药卫生—心血管疾病]