Bavbek Nuket, Yilmaz Hakki, Erdemli Haci Kemal, Selcuki Yusuf, Duranay Murat, Akçay Ali
Department of Nephrology, Turgut Ozal University Medical School , Ankara , Turkey .
Ren Fail. 2014 Mar;36(2):187-90. doi: 10.3109/0886022X.2013.836750. Epub 2013 Sep 24.
We aimed to investigate the QT dispersion and corrected QT (QTc) dispersion which are suggested as the signals of ventricular arrhythmias, in patients on maintenance CAPD and to evaluate the correlation between iron stores and these electrocardiographic parameters.
Fifty-eight patients on maintenance CAPD and 19 healthy age- and sex-matched adults without cardiac disease were included. The PD patients were divided into two groups according to whether their computerized measurements of QTc dispersion were longer than 65 ms.
Although QT interval was statistically significantly shorter in control group (34 ± 28 vs. 43 ± 34 ms; p < 0.05), there was no significant difference in regards to the QTc, QT dispersion and QTc dispersion between two groups. PD patients with QTc dispersion longer than 65 ms had higher levels of serum ferritin (p = 0.038) and transferrin saturation (TSAT; p = 0.022) than the others. QTc dispersion were positively correlated with ferritin (r = 0.469, p < 0.01) and TSAT (r = 0.430, p < 0.01) in CAPD patients.
Although prolonged QTc, QT dispersion and QTc dispersion were suggested as the markers of ventricular arrhythmias we did not find any significant difference in regards to these parameters between control patients and CAPD patients. But the high body iron stores in these patients increase the risk of increased QT dispersion. The concern over iron overload in dialysis patients is not only because of its oxidative toxicity, but also its precipitation of arrhythmias, which may be measured by the surrogate marker of QTc dispersion.
我们旨在研究作为室性心律失常信号的QT离散度和校正QT（QTc）离散度，这些指标在维持性持续性非卧床腹膜透析（CAPD）患者中，并评估铁储备与这些心电图参数之间的相关性。
纳入58例维持性CAPD患者和19例年龄、性别匹配且无心脏病的健康成年人。根据计算机测量的QTc离散度是否长于65毫秒，将腹膜透析患者分为两组。
虽然对照组的QT间期在统计学上显著较短（34±28 vs. 43±34毫秒；p<0.05），但两组之间的QTc、QT离散度和QTc离散度并无显著差异。QTc离散度长于65毫秒的腹膜透析患者血清铁蛋白水平（p = 0.038）和转铁蛋白饱和度（TSAT；p = 0.022）高于其他患者。在CAPD患者中，QTc离散度与铁蛋白（r = 0.469，p<0.01）和TSAT（r = 0.430，p<0.01）呈正相关。
虽然QTc延长、QT离散度和QTc离散度被认为是室性心律失常的标志物，但我们发现对照组患者和CAPD患者在这些参数方面没有任何显著差异。但这些患者体内较高的铁储备增加了QT离散度增加的风险。对透析患者铁过载的关注不仅在于其氧化毒性，还在于其引发心律失常，而QTc离散度的替代标志物可能可用于测量这种风险。
