Ozdemir Durgul, Ozdemir Nail, Unal Nurettin, Tektas Sevket
Department of Pediatrics, Dokuz Eylul University, School of Medicine, Turkey.
Pediatr Emerg Care. 2005 Oct;21(10):658-61. doi: 10.1097/01.pec.0000181427.25342.e0.
Corrected QT (QTc) interval prolongation has been described after subarachnoid hemorrhage and head injury in adults. Abnormal QTc prolongation is associated with a higher risk of ventricular arrhythmias. The aim of this study was to analyze QTc interval and QTc dispersion in children with severe head trauma.
Forty-three patients with severe head trauma and 49 children with no or only mild head injury as controls were enrolled in the study. QT interval from standard 12-lead electrocardiogram immediately after admission was calculated. QT interval was corrected by heart rate according to Bazett formula, and then QTc dispersion was calculated. At the same time, levels of serum electrolytes were measured.
Although no significant difference in terms of age, sex, and R-R interval was found, QTc interval and QTc dispersion values were significantly increased in the patients with severe head trauma compared with those with no or only mild head injury (QTc, 447 +/- 31 vs. 409 +/- 27 milliseconds; QTc dispersion, 77 +/- 22 vs. 52 +/- 16 milliseconds, respectively). When the patients with severe head trauma were categorized as those with or without intracranial hemorrhage, both QTc interval and QTc dispersion were significantly greater in those with intracranial hemorrhage. These electrocardiographic parameters were inversely associated with Glasgow Coma Scale score, serum calcium levels, and, at a lesser degree, potassium levels.
Children with severe head trauma, especially those with intracranial hemorrhage have longer QTc interval and greater QTc dispersion.
蛛网膜下腔出血和成人头部损伤后已出现校正QT（QTc）间期延长。QTc异常延长与室性心律失常风险较高相关。本研究的目的是分析重度颅脑外伤患儿的QTc间期和QTc离散度。
本研究纳入43例重度颅脑外伤患儿和49例无头部损伤或仅有轻度头部损伤的儿童作为对照。计算入院后即刻标准12导联心电图的QT间期。根据Bazett公式用心率校正QT间期，然后计算QTc离散度。同时，测定血清电解质水平。
尽管在年龄、性别和R-R间期方面未发现显著差异，但与无头部损伤或仅有轻度头部损伤的儿童相比，重度颅脑外伤患儿的QTc间期和QTc离散度值显著升高（QTc分别为447±31 vs. 409±27毫秒；QTc离散度分别为77±22 vs. 52±16毫秒）。将重度颅脑外伤患儿分为有或无颅内出血两组，有颅内出血组的QTc间期和QTc离散度均显著更高。这些心电图参数与格拉斯哥昏迷量表评分、血清钙水平呈负相关，与钾水平的相关性较弱。
重度颅脑外伤患儿，尤其是有颅内出血的患儿，QTc间期更长，QTc离散度更大。
