血液透析后QT间期、QT离散度及T波振幅的变化。
Changes in the QT intervals, QT dispersion, and amplitude of T waves after hemodialysis.
作者信息
Drighil Abdenasser, Madias John E, Benjelloun Meryem, Kamoum Hanane, Bennis Ahmed, Azzouzi Leila, Yazidi Asma, Ramdani Benyouness
机构信息
Department of Cardiology, Ibn Rochd University Hospital, Casablanca, Morocco.
出版信息
Ann Noninvasive Electrocardiol. 2007 Apr;12(2):137-44. doi: 10.1111/j.1542-474X.2007.00152.x.
BACKGROUND
Increased QT dispersion (QTd) has been associated with an increased risk for ventricular arrhythmias and sudden death in the general population and in various clinical states.
METHODS
We investigated the impact of hemodialysis (HD) on QT, QTd, and T-wave amplitude in subjects with end-stage renal failure. Data on 49 patients on chronic HD were studied. The QT, QTd, and the sum of amplitude of T waves (SigmaT) in millimetre in the 12 ECG leads, along with a host of other ECG parameters, body weight, blood pressure, heart rate, electrolytes, and hemoglobin/hematocrit were measured before and immediately after HD.
RESULTS
QT decreased (380.9 +/- 38.4-363.5 +/- 36.8 ms, P = 0.001), the QTc did not change (406.2 +/- 30.8-405.4 +/- 32.2 ms, P = 0.8), the QTd increased (31.3 +/- 14.6-43.9 +/- 18.6 ms, P = 0.003), and the SigmaT decreased (32.3 +/- 15.7-25.9 +/- 12.6 mm, P = 0.0001) after HD. There was no correlation between the change in QTd and the changes in serum cations, heart rate, the subjects' weight, T-wave duration, and SigmaT. However, the change in QTc correlated inversely with the change in serum Ca(++) (r =-0.339, P = 0.021).
CONCLUSION
QTd increased, the SigmaT decreased, and the QTc and T-wave duration remained stable, after HD. The QTd increase, although may be real, could also reflect measurement errors stemming from the decrease in the amplitude of T waves (as shown recently), imparted by HD; this requires clarification, to use QTd in patient on HD.
背景
QT离散度（QTd）增加与普通人群及各种临床状态下室性心律失常和猝死风险增加相关。
方法
我们研究了血液透析（HD）对终末期肾衰竭患者QT、QTd和T波振幅的影响。对49例接受慢性HD的患者的数据进行了研究。在HD前及HD后即刻测量12导联心电图中的QT、QTd以及T波振幅总和（SigmaT，单位为毫米），同时测量一系列其他心电图参数、体重、血压、心率、电解质以及血红蛋白/血细胞比容。
结果
HD后QT缩短（从380.9±38.4毫秒降至363.5±36.8毫秒，P = 0.001），校正QT间期（QTc）未改变（从406.2±30.8毫秒变为405.4±32.2毫秒，P = 0.8），QTd增加（从31.3±14.6毫秒增至43.9±18.6毫秒，P = 0.003），SigmaT降低（从32.3±15.7毫米降至25.9±12.6毫米，P = 0.0001）。QTd的变化与血清阳离子变化、心率、患者体重、T波时限及SigmaT的变化之间无相关性。然而，QTc的变化与血清钙离子（Ca(++)）的变化呈负相关（r = -0.339，P = 0.021）。
结论
HD后QTd增加，SigmaT降低，QTc和T波时限保持稳定。QTd的增加虽然可能是真实的，但也可能反映了HD导致的T波振幅降低（如最近所示）所带来的测量误差；这一点需要进一步阐明，以便在HD患者中使用QTd。
Zotero 插件