乙型肝炎后肝硬化患者Q-Tc间期的变化及其临床意义  

Changes of Q-Tc interval in patients with posthepatitis B cirrhosis and its clinical significance

作　　者：陆华美[1,2] 蔡菁 袁志萍 LU Huamei;CAI Jing;YUAN Zhiping(Department of Gastroenterology,Wujin Hospital Affiliated to Jiangsu University,Changzhou,Jiangsu,213002;Department of Gastroenterology,Wujin Clinical College of Xuzhou Medical University,Changzhou,Jiangsu,213002)

机构地区：[1]江苏大学附属武进医院消化内科,江苏常州213002 [2]徐州医科大学武进临床学院消化内科,江苏常州213002

出　　处：《实用临床医药杂志》2021年第19期57-61,共5页Journal of Clinical Medicine in Practice

基　　金：江苏省常州市科技指导项目(WZ201929);江苏省常州市武进区科技支撑计划(社会发展)(WS201925);江苏省常州市“龙城医星”卫生青年科技人才托举工程。

摘　　要：目的分析乙型肝炎后肝硬化患者心电图Q-Tc的变化及其相关因素。方法回顾性分析乙型病毒性肝炎肝硬化患者80例(肝硬化组)的临床资料。比较肝硬化组和30例慢性乙肝患者(对照组)一般资料。分析心电图Q-Tc间期的变化;分析Child-Pugh评分、分级与肝硬化程度的关系。结果肝硬化组患者的血清钠、血清钙、血清白蛋白、血红蛋白、血小板低于对照组,血清胆红素、谷草转氨酶高于对照组,凝血酶原时间长于对照组,差异有统计学意义(P<0.05)。肝硬化组的心率高于对照组,Q-Tc间期长于对照组,差异有统计学意义(P<0.05)。Q-Tc间期与Child-Pugh评分(r=0.38,P<0.01)呈正相关,而与血清白蛋白(r=-0.31,P=0.006)、血红蛋白(r=-0.29,P=0.010)呈负相关;Child-Pugh评分是影响肝硬化患者心电图Q-Tc间期的独立相关因素。结论肝硬化患者存在Q-Tc延长,且和Child-Pugh评分相关。检测Q-Tc间期变化,对了解肝硬化患者病情严重程度有临床指导意义。Objective To analyze the changes of Q-Tc in electrocardiogram and its related factors in patients with posthepatitis B cirrhosis.Methods The clinical data of 80 patients with viral hepatitis B cirrhosis(cirrhosis group)was retrospectively analyzed.The general data of the cirrhosis group and 30 chronic hepatitis B patients(control group)was compared.The changes of electrocardiogram in Q-Tc interval were analyzed.The relationships between Child-Pugh score,grade and degree of cirrhosis was analyzed.Results The levels of serum sodium,serum calcium,serum albumin,hemoglobin and platelet in the cirrhosis group were significantly lower,while the levels of serum bilirubin and aspartate aminotransferase were significantly higher,and prothrombin time was significantly longer than that in the control group(P<0.05).The heart rate in the cirrhosis group was significantly higner,and the Q-Tc interval was significantly longer than that in the control group(P<0.05).The Q-Tc interval was positively correlated with Child-Pugh score(r=0.38,P<0.01),but negatively correlated with serum albumin(r=-0.31,P=0.006)and hemoglobin(r=-0.29,P=0.010);Child-pugh score was an independent correlation factor affecting the electrocardiogram Q-Tc interval in patients with cirrhosis.Conclusion Q-Tc is prolonged in patients with cirrhosis and it is correlated with Child-Pugh score.The detection of Q-Tc interval changes has clinical guiding significance for knowing the severity of cirrhosis.

关 键 词：乙型肝硬化 心电图 Q-TC间期 CHILD-PUGH评分 

分 类 号：R540.4[医药卫生—心血管疾病] R575.2[医药卫生—内科学]