Li Li, Liu Huai-rong, Shu Jun-lian, Xi Xiao-ping, Wang Yan
Department of Cardiology, General Hospital of Armed Police Forces, Beijing 100039, China.
Zhonghua Yi Xue Za Zhi. 2007 Oct 16;87(38):2717-8.
To investigate the relationship between the prolonged corrected QT interval (Q-Tc) and the severity and prognosis of patients with hepatic cirrhosis.
Electrocardiography was conducted on 126 patients with hepatic cirrhosis, 86 males and 40 females, aged (62 +/- 16), 38 of Child-Pugh grade A, 64 of grade B, and 24 of grade C, and 126 sex- and aged-matched healthy persons as controls. Peripheral blood samples were collected to undergo the examination of prothrombin time, and serum albumin, total bilirubin, potassium, calcium, ALT, AST, gamma glutamyl transferase, and alkaline phosphatase. The relationship between the Q-Tc and other parameters were analyzed. Twenty cirrhotic patients underwent liver transplantation.
The Q-Tc value of the cirrhosis patients was (421 +/- 38) ms, significantly longer than that of the controls (386 +/- 25) ms. The Q-Tc prolongation rate of the cirrhosis patients was 46.93% (58/126), significantly higher than that of the controls (1.58%, 2/126, P < 0.01). The Q-Tc prolongation rates of the patients of Child-Pugh grade B and C were 56.89% and 59.60% respectively, both significantly higher than that of the patients of grade A (21.05%, both P < 0.01). Linear regression analysis showed that Q-Tc was positively correlated with the Child-Pugh score. Q-Tc was not significantly correlated with the biochemical indicators mentioned above. The prolonged Q-Tc became normal in 17 of the 20 patients undergoing liver transplantation and became shorter in 3 cases one year after the operation.
Q-Tc prolongation exits in hepatic cirrhosis and the Q-Tc prolongation rate increases along with the severity of disease. After liver transplantation the prolonged Q-Tc may recover to normal Q-Tc prolongation can be used to assess the severity and prognosis of hepatic cirrhosis.
探讨校正QT间期（Q-Tc）延长与肝硬化患者病情严重程度及预后的关系。
对126例肝硬化患者进行心电图检查，其中男性86例，女性40例，年龄（62±16）岁，Child-Pugh A级38例，B级64例，C级24例，并选取126例性别、年龄匹配的健康人作为对照。采集外周血样本进行凝血酶原时间、血清白蛋白、总胆红素、钾、钙、谷丙转氨酶、谷草转氨酶、γ-谷氨酰转移酶和碱性磷酸酶检查。分析Q-Tc与其他参数之间的关系。20例肝硬化患者接受了肝移植。
肝硬化患者的Q-Tc值为（421±38）ms，显著长于对照组（386±25）ms。肝硬化患者的Q-Tc延长率为46.93%（58/126），显著高于对照组（1.58%，2/126，P<0.01）。Child-Pugh B级和C级患者的Q-Tc延长率分别为56.89%和59.60%，均显著高于A级患者（21.05%，均P<0.01）。线性回归分析显示，Q-Tc与Child-Pugh评分呈正相关。Q-Tc与上述生化指标无显著相关性。20例接受肝移植的患者中，17例术后1年Q-Tc延长恢复正常，3例缩短。
肝硬化患者存在Q-Tc延长，且Q-Tc延长率随疾病严重程度增加而升高。肝移植后延长的Q-Tc可能恢复正常，Q-Tc延长可用于评估肝硬化的严重程度和预后。
