Duraković Z, Misigoj-Duraković M, Corović N
Department of Internal Medicine, Rebro University Hospital, School of Medicine, Zagreb, Croatia.
Int J Cardiol. 2001 Sep-Oct;80(2-3):221-6. doi: 10.1016/s0167-5273(01)00498-3.
Twenty elderly patients (12 females and 8 males, aged 65-88 years) were treated because of hypothermia: 11 suffered from moderate (35-32 degrees C) and nine from severe hypothermia (<32 degrees C). The control group consisted of 20 age and sex-matched healthy elderly persons. Twelve-channel electrocardiograms were recorded on admission and during hospitalization. In patients with moderate hypothermia Osborn wave was present in eight of 11, and minimal Osborn wave in three of 11; in severe hypothermia Osborn wave was seen in seven of nine, and minimal in two of nine. The corrected Q-T interval (Q-Tc) was analyzed according to the formula of Bazett: measured Q-T(s)/ radical R-R(s). The JT and the corrected JT interval (JTc) were measured according to the formula: JT=Q-T-QRS. The Q-T interval index (Q-TI) was measured according to the formula: (Q-TI:656)x(HR+100); and the JT interval index JTI: (JT:518)x(HR+100). The dispersion of the Q-Tc (JTc) was defined as the difference between maximum and minimum measured Q-Tc interval (JTc). The Q-Tc interval in the group with hypothermia was 651.41+/-130.06 ms, while in the control group it was 398.14+/-76.21 ms (P<0.001). The Q-Tc dispersion in the group with hypothermia was 91.39+/-51.98, and in the control group 33.21+/-10.25 ms (P<0.001). The Q-TcI in the group with hypothermia was 89.91+/-21.44, and in the control group 39.56+/-9.41 ms ((P<0.001). The JTc in the group with hypothermia was 542.66+/-132.74, in the control group: 328.06+/-76.92 (P<0.001). The JTc dispersion in the group with hypothermia was 79.35+/-46.22, and in the control group 28.53+/-7.99 (P<0.0001). The JTcI in the group with hypothermia was 93.06+/-17.38, in the control group it was 40.23+/-7.59 (P<0.001). The mean values of the Q-TcI were greater than Q-TI, and the mean values of the JTcI were greater than JTI, but the difference was not significant (P>0.10). The mean values of the JTcI were greater than Q-TcI, but the difference was not significant as well (P>0.05). There was no correlation between rectal temperature and dispersion of Q-T, Q-Tc, JT, JTc, and Osborn wave. The maximum Osborn wave and the maximum Q-T interval were registered in anteroseptal leads (V(2)-V(3)). The dispersion of the Q-Tc and of the JTc lasted more than Osborn wave. There was no correlation between rectal temperature and PR interval, RR interval and QRS duration. The prolonged dispersion of the Q-Tc (and JTc) last 24-48 h longer than Osborn wave.
20名老年患者(12名女性和8名男性,年龄65 - 88岁)因体温过低接受治疗:11例为中度体温过低(35 - 32摄氏度),9例为重度体温过低(<32摄氏度)。对照组由20名年龄和性别匹配的健康老年人组成。入院时和住院期间记录12导联心电图。中度体温过低患者中,11例中有8例出现奥斯本波,11例中有3例出现最小奥斯本波;重度体温过低患者中,9例中有7例出现奥斯本波,9例中有2例出现最小奥斯本波。根据巴泽特公式分析校正QT间期(QTc):测量的QT(秒)/根号下RR(秒)。根据公式JT = QT - QRS测量JT和校正JT间期(JTc)。根据公式(QT间期指数(Q - TI):656)×(心率 + 100)测量QT间期指数(Q - TI);JT间期指数JTI:(JT:518)×(心率 + 100)。QTc(JTc)离散度定义为测量的最大和最小QTc间期(JTc)之间的差值。体温过低组的QTc间期为651.41±130.06毫秒,而对照组为398.14±76.21毫秒(P < 0.001)。体温过低组的QTc离散度为91.39±51.98,对照组为33.21±10.25毫秒(P < 0.001)。体温过低组的QTcI为89.91±21.44,对照组为39.56±9.41毫秒(P < 0.001)。体温过低组的JTc为542.66±132.74,对照组为328.06±76.92(P < 0.001)。体温过低组的JTc离散度为79.35±46.22,对照组为28.53±7.99(P < 0.0001)。体温过低组的JTcI为93.06±17.38,对照组为40.23±7.59(P < 0.001)。QTcI的平均值大于Q - TI,JTcI的平均值大于JTI,但差异无统计学意义(P > 0.10)。JTcI的平均值大于QTcI,但差异也无统计学意义(P > 0.05)。直肠温度与QT、QTc、JT、JTc离散度及奥斯本波之间无相关性。最大奥斯本波和最大QT间期出现在前间隔导联(V₂ - V₃)。QTc和JTc离散度持续时间比奥斯本波长。直肠温度与PR间期、RR间期及QRS时限之间无相关性。QTc(和JTc)延长的离散度比奥斯本波持续24 - 48小时更长。