慢性乙型肝炎肝硬化患者12导联心电图变化及其与肝功能分级的关系  

Changes of 12-lead electrocardiogram in patients with chronic hepatitis B and cirrhosis and the relationship with liver function grading

作　　者：鲁慧先 姚羽 叶伟[3] LU Hui-xian;YAO Yu;YE Wei(Department of Functional Examination,the Second Hospital of Nanjing,Nanjing 210003,Jiangsu,China;Department of Respiratory Medicine,the Second Hospital of Nanjing,Nanjing 210003,Jiangsu,China;Department of Liver Cirrhosis Diagnostic and Treatment Center,the Second Hospital of Nanjing,Nanjing 210003,Jiangsu,China)

机构地区：[1]南京市第二医院,功能检查科,江苏南京210003 [2]南京市第二医院,呼吸科,江苏南京210003 [3]南京市第二医院,肝硬化诊疗中心,江苏南京210003

出　　处：《川北医学院学报》2024年第12期1604-1607,共4页Journal of North Sichuan Medical College

基　　金：国家自然科学基金资助项目(82203561)。

摘　　要：目的:研究慢性乙型肝炎(CHB)肝硬化患者12导联心电图变化及其与肝功能分级的关系。方法:回顾性分析CHB患者的临床资料,根据其是否发生肝硬化将患者分为观察组(n=83)与对照组(n=37),并根据Child-Pugh分级评估结果,将观察组患者分为A级组(n=38)、B级组(n=25)和C级组(n=20)。收集并比较患者临床资料及12导联心电图检测结果,并分析CHB肝硬化患者12导联心电图变化与肝功能分级的关系。结果:观察组患者胆红素、ALT、AST、Q-T间期、Q-Tc间期均高于对照组(P<0.05),白蛋白水平低于对照组(P<0.05)。A、B、C级各组患者的白蛋白、胆红素、AST、Q-T间期及Q-Tc间期水平比较,差异均有统计学意义(P<0.05),且B级组和C级组白蛋白均低于A级组,胆红素、AST、Q-T间期及Q-Tc间期水平均高于A级组(P<0.05)。经Pearson相关性分析显示,CHB肝硬化患者白蛋白水平与肝功能分级负相关;胆红素、AST、Q-T间期及Q-Tc间期水平与其肝功能分级正相关(P<0.05)。结论:CHB肝硬化患者肝功能分级程度越严重,其12导联心电图检测结果异常越明显。Objective:To study the changes of 12-lead electrocardiogram in patients with chronic hepatitis B(CHB)and cirrhosis,and the relationship with liver function grading.Methods:The clinical data of CHB patients were retrospectively collected.Patients included were divided into an observation group(with,n=83)and a control group(without,n=37)according to the presence or absence of cirrhosis.According to Child-Pugh score,patients in the observation group were divided into grade A group(n=38),grade B group(n=25)and grade C group(n=20).Clinical data and 12-lead electrocardiography results of different groups were compared.The relationship between the changes of 12-lead electrocardiogram and liver function grading in patients with CHB and cirrhosis was analyzed.Results:The levels of bilirubin,ALT and AST,Q-T interval and Q-Tc interval in the observation group were higher than those in the control group,and the level of albumin was lower than that in the control group(P<0.05).There were statistically significant differences in albumin,bilirubin,AST,Q-T interval and Q-Tc interval among patients with different grades of liver function.Albumin levels in grade B group and grade C group were lower than those in grade A group.The levels of bilirubin and AST,Q-T interval and Q-Tc interval were higher than those in grade A group(P<0.05).Pearson correlation analysis found that albumin level was negatively correlated with liver function grading in patients with CHB and cirrhosis.The levels of bilirubin and AST,Q-T interval and Q-Tc interval were positively correlated with liver function grading(P<0.05).Conclusion:The more severe the liver function grading in patients with CHB and cirrhosis,the more obvious the abnormalities in their 12-lead electrocardiography results.

关 键 词：慢性乙型肝炎 肝硬化 12导联心电图 肝功能分级 

分 类 号：R657.31[医药卫生—外科学]