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QT 和 JT 离散度与新生儿 Bartter 综合征患儿心功能的关系:一项初步研究。

QT and JT dispersion and cardiac performance in children with neonatal Bartter syndrome: a pilot study.

机构信息

Department of Pediatric Nephrology and Rheumatology, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey.

出版信息

Pediatr Nephrol. 2013 Oct;28(10):1969-74. doi: 10.1007/s00467-013-2517-5. Epub 2013 Jun 13.

Abstract

BACKGROUND

QT dispersion and JT dispersion are simple noninvasive arrhythmogenic markers that can be used to assess the homogeneity of cardiac repolarization. The aim of this study was to assess QT and JT dispersion and their relation with left ventricular systolic and diastolic functions in children with Bartter syndrome (BS).

METHODS

Nine neonatal patients with BS (median age 9.7 years) and 20 controls (median age 8 years) were investigated at rest. Both study and control subjects underwent electrocardiography (ECG) in which the interval between two R waves and QT intervals, corrected QT, QT dispersion, corrected QT dispersion, JT, corrected JT, JT dispersion and corrected JT dispersion were measured with 12-lead ECG. Two-dimensional, Doppler echocardiographic examinations were performed.

RESULTS

Patients and controls did not differ for gender and for serum levels of potassium, magnesium, and calcium (p > 0.05). Both study and control subjects had normal echocardiographic examination and baseline myocardial performance indexes. The QT dispersion and JT dispersion were significantly prolonged in patients with BS compared to those of the controls {37.5 ms [interquartile range (IQR) 32.5-40] vs. 25.5 ms (IQR 20-30), respectively, p = 0.014 and 37.5 ms (IQR 27.5-40) vs. 22.5 ms (IQR 20-30), respectively, p = 0.003}.

CONCLUSIONS

Elevated QT and JT dispersion during asymptomatic and normokalemic periods may be risk factors for the development of cardiac complications and arrhythmias in children with BS. In these patients the need for systematic cardiac screening and management protocol is extremely important for effective prevention.

摘要

背景

QT 离散度和 JT 离散度是简单的无创性致心律失常标志物,可用于评估心脏复极的均一性。本研究旨在评估 QT 和 JT 离散度及其与巴特综合征(BS)患儿左心室收缩和舒张功能的关系。

方法

研究纳入 9 例新生儿 BS 患者(中位年龄 9.7 岁)和 20 例对照(中位年龄 8 岁),均在静息状态下接受检查。所有研究对象均行心电图(ECG)检查,测量 12 导联心电图上两个 R 波之间的间期和 QT 间期、校正 QT、QT 离散度、校正 QT 离散度、JT、校正 JT、JT 离散度和校正 JT 离散度。行二维、多普勒超声心动图检查。

结果

患者和对照在性别和血清钾、镁、钙水平方面无差异(p>0.05)。两组研究对象的超声心动图检查和基线心肌做功指数均正常。BS 患者的 QT 离散度和 JT 离散度明显长于对照组[37.5ms(IQR 32.5-40)比 25.5ms(IQR 20-30),p=0.014;37.5ms(IQR 27.5-40)比 22.5ms(IQR 20-30),p=0.003]。

结论

无症状和血钾正常期 QT 和 JT 离散度升高可能是 BS 患儿发生心脏并发症和心律失常的危险因素。这些患者需要进行系统的心脏筛查和管理方案,以有效预防。

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