Department of Gastroenterology, Goztepe Training and Research Hospital, 34470 Istanbul, Turkey.
World J Gastroenterol. 2013 Jan 7;19(1):65-71. doi: 10.3748/wjg.v19.i1.65.
To investigate the frequency and factors of prolonged QT dispersion that may lead to severe ventricular arrhythmias in patients with inflammatory bowel disease (IBD).
This study included 63 ulcerative colitis (UC) and 41 Crohn's disease (CD) patients. Forty-seven healthy patients were included as the control group. Heart rate was calculated using electrocardiography, corrected QT dispersion (QTcd) and the Bazett's formula. Homeostasis model assessment (HOMA) was used to determine insulin resistance (IR). HOMA values < 1 were considered normal and values > 2.5 indicated a high probability of IR.
Prolonged QTcd was found in 12.2% of UC patients, and in 14.5% of CD patients compared with the control group (P < 0.05). A significant difference was found between the insulin values (CD: 10.95 ± 6.10 vs 6.44 ± 3.28, P < 0.05; UC: 10.88 ± 7.19 vs 7.20 ± 4.54, P < 0.05) and HOMA (CD: 2.56 ± 1.43 vs 1.42 ± 0.75, P < 0.05; UC: 2.94 ± 1.88 vs 1.90 ± 1.09, P < 0.05) in UC and CD patients with and without prolonged QTcd. Disease behavior types were determined in CD patients with prolonged QTcd. Increased systolic arterial pressure (125 ± 13.81 vs 114.09 ± 8.73, P < 0.01) and age (48.67 ± 13.93 vs 39.57 ± 11.58, P < 0.05) in UC patients were significantly associated with prolonged QTcd.
Our data show that IBD patients have prolonged QTcd in relation to controls. The routine follow-up of IBD patients should include determination of HOMA, insulin values and electrocardiogram examination.
研究炎症性肠病(IBD)患者中可能导致严重室性心律失常的 QT 离散度延长的频率和相关因素。
本研究纳入了 63 例溃疡性结肠炎(UC)患者和 41 例克罗恩病(CD)患者。47 例健康患者作为对照组。通过心电图计算心率、校正 QT 离散度(QTcd)和 Bazett 公式。采用稳态模型评估(HOMA)来确定胰岛素抵抗(IR)。HOMA 值<1 为正常,值>2.5 表示 IR 可能性高。
UC 患者中有 12.2%、CD 患者中有 14.5%存在 QTcd 延长,与对照组相比差异有统计学意义(P<0.05)。CD 患者的胰岛素值(10.95±6.10 比 6.44±3.28,P<0.05)和 HOMA(2.56±1.43 比 1.42±0.75,P<0.05)以及 UC 患者的胰岛素值(10.88±7.19 比 7.20±4.54,P<0.05)和 HOMA(2.94±1.88 比 1.90±1.09,P<0.05)在存在和不存在 QTcd 延长的 UC 和 CD 患者之间存在显著差异。在存在 QTcd 延长的 CD 患者中确定了疾病行为类型。UC 患者的收缩压升高(125±13.81 比 114.09±8.73,P<0.01)和年龄(48.67±13.93 比 39.57±11.58,P<0.05)与 QTcd 延长显著相关。
我们的数据表明,IBD 患者与对照组相比存在 QTcd 延长。IBD 患者的常规随访应包括 HOMA、胰岛素值和心电图检查。