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QT 间期离散度在无明显冠状动脉异常的北印度川崎病患儿中的变化。

QT interval dispersion in North Indian children with Kawasaki disease without overt coronary artery abnormalities.

机构信息

Pediatric Allergy Immunology Unit, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Rheumatol Int. 2011 Mar;31(3):301-5. doi: 10.1007/s00296-009-1252-5. Epub 2009 Dec 13.

Abstract

Increased QT interval dispersion has been associated with an increased risk for ventricular arrhythmias and sudden cardiac events. We examined the QT interval dispersion in 20 North Indian children with Kawasaki disease (KD) with no coronary artery abnormalities on echocardiography compared the same with matched controls. The study population consisted of 20 children in convalescent phase of KD and 20 age and sex-matched healthy controls. Intervals were measured with the use of a digital caliper with least count of 0.01 mm by a single blinded observer. The QTc dispersion was calculated as the difference between the maximum and minimum corrected QT intervals in 12 and 8 leads (i.e. the 6 precordial leads, the shortest extremity lead, and the median of the 5 other extremity leads). Of the 480 leads obtained (12 per subject), 36 were excluded from analysis (15 because of poor T wave formation and 11 because of presence of U waves). Children with KD had significantly higher QTc dispersion in 12 lead (67.08 ± 17.72 ms compared to 47.63 ± 16.48 ms in controls P ≤ 0.001) as well as 8 lead (60.51 ± 18.54 ms compared to 42.92 ± 18.03 ms in controls P ≤ 0.001) analysis. There was no correlation between delay in IVIG therapy and QT interval dispersion. In conclusion, QT interval dispersion is significantly increased in North Indian children with KD. The dispersion is indicative of inhomogenous ventricular repolarization and may represent increased risk for developing ventricular arrhythmia in this population.

摘要

QT 间期离散度增加与室性心律失常和心脏性猝死的风险增加相关。我们检查了 20 名在超声心动图上无冠状动脉异常的印度北部川崎病(KD)患儿的 QT 间期离散度,并将其与匹配的对照组进行了比较。研究人群包括 20 名川崎病恢复期的儿童和 20 名年龄和性别匹配的健康对照组。间隔使用数字卡尺测量,最小计数为 0.01 毫米,由单个盲法观察者进行。QTc 离散度的计算方法是在 12 导联和 8 导联(即 6 个胸前导联、最短的肢体导联和 5 个其他肢体导联的中位数)中测量最大和最小校正 QT 间期之间的差异。在获得的 480 个导联中(每个患者 12 个),有 36 个被排除在分析之外(15 个导联由于 T 波形成不良,11 个导联由于 U 波存在)。KD 患儿的 12 导联(67.08 ± 17.72 ms 与对照组的 47.63 ± 16.48 ms 相比,P ≤ 0.001)和 8 导联(60.51 ± 18.54 ms 与对照组的 42.92 ± 18.03 ms 相比,P ≤ 0.001)QTc 离散度显著升高。IVIG 治疗延迟与 QT 间期离散度之间无相关性。总之,印度北部 KD 患儿的 QT 间期离散度显著增加。这种离散度表明心室复极不均匀,可能代表该人群发生室性心律失常的风险增加。

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