急性病患者血清铁蛋白水平与心电图特征之间的关系。
The relationship between serum ferritin levels and electrocardiogram characteristics in acutely ill patients.
作者信息
Laudanski Krzysztof, Ali Huma, Himmel Andrew, Godula Kasia, Stettmeier Mary, Calvocoressi Lisa
机构信息
Department of Anesthesiology and Critical Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts;
出版信息
Exp Clin Cardiol. 2009 Fall;14(3):38-41.
BACKGROUND
Cardiac arrhythmias are common comorbidities among acutely ill patients admitted to hospitals. An abnormal iron metabolism may contribute to the abnormalities in the conduction and propagation of action potentials through myocardium.
OBJECTIVE
To determine whether serum indexes of iron metabolism correlate with electrocardiogram (ECG) changes.
METHODS
In the present retrospective, pilot chart review, serum levels of iron, ferritin, Na(+), K(+), Mg(2+), Ca(2+) and total iron-binding capacity in 77 hospitalized patients with acute illness were correlated with ECG variables.
RESULTS
The serum ferritin level correlated strongly (r=0.49) with QT/QTs interval. There were three subjects with QT prolongation (longer than 450 ms) within the high serum ferritin (576 ng/mL or greater) group versus subjects with low ferritin. Multiple regression analysis showed that serum ferritin level and serum iron level contributed to the variance in the QT/QTs prolongation. No other correlation between the studied serum markers and ECG characteristics were found.
CONCLUSION
The present study suggests that serum ferritin and iron levels affect the QT interval in a variety of medical conditions, possibly contributing to the emergence of fatal cardiac arrhythmias.
背景
心律失常是住院急性病患者常见的合并症。铁代谢异常可能导致动作电位在心肌中的传导和传播异常。
目的
确定铁代谢的血清指标是否与心电图（ECG）变化相关。
方法
在本次回顾性试点图表审查中，对77例住院急性病患者的血清铁、铁蛋白、钠（Na⁺）、钾（K⁺）、镁（Mg²⁺）、钙（Ca²⁺）水平及总铁结合力与心电图变量进行相关性分析。
结果
血清铁蛋白水平与QT/QTs间期呈强相关（r = 0.49）。高血清铁蛋白（576 ng/mL及以上）组中有3例QT延长（超过450 ms），而低铁蛋白组中无此情况。多元回归分析表明，血清铁蛋白水平和血清铁水平导致QT/QTs延长存在差异。未发现所研究的血清标志物与心电图特征之间的其他相关性。
结论
本研究表明，血清铁蛋白和铁水平在多种医疗状况下影响QT间期，可能导致致命性心律失常的发生。
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