镰状细胞贫血中的心脏自主神经功能障碍及其与QT参数的相关性。
Cardiac autonomic dysfunction in sickle cell anaemia and its correlation with QT parameters.
作者信息
Kolo Philip Manma, Sanya Emmanuel Olatunde, Olanrewaju Timothy O, Fawibe Ademola E, Soladoye Ayodele
机构信息
Department of Medicine, University of Ilorin, Ilorin, Nigeria.
Department of Physiology, University of Ilorin, Ilorin, Nigeria.
出版信息
Niger Med J. 2013 Nov;54(6):382-5. doi: 10.4103/0300-1652.126288.
BACKGROUND
Abnormalities of QT parameters together with cardiac autonomic neuropathy (CAN) confer significant risks of cardiac morbidity and mortality in patients with diabetes mellitus. We questioned whether or not CAN influences occurrence of QT interval prolongation and dispersion in patients with sickle cell anaemia (SCA).
MATERIALS AND METHODS
Forty stable adult sickle cell patients with 44 healthy haemoglobin AA controls were studied. Baseline electrocardiograms were obtained and cardiovascular autonomic function tests were performed using standard protocols.
RESULTS
Mean corrected QT (QTc) in sickle cell patients was significantly higher (P = 0.001) than the mean of controls. Similarly, mean QT dispersion (QTcd) was higher (P = 0.001) in the former than in the latter. Mean QTc in patients with CAN was longer than patients with normal autonomic function (461 ± 26 ms versus 411 ± 23 ms), P = 0.001 (OR of 17.1, CI 3.48-83.71). Similarly, QTcd was higher (P = 0.001) in patients with CAN than those with normal cardiac autonomic function. Positive correlations were found between CAN with QTc and QTcd (r = 0.604, P = 0.001, r = 0.523, P = 0.001, respectively).
CONCLUSION
CAN is a risk factor for abnormalities of QT parameters in SCA and both may be harbinger for cardiac death.
背景
QT参数异常与心脏自主神经病变（CAN）会给糖尿病患者带来显著的心脏发病和死亡风险。我们质疑CAN是否会影响镰状细胞贫血（SCA）患者QT间期延长和离散度的发生。
材料与方法
研究了40例病情稳定的成年镰状细胞患者以及44例健康的血红蛋白AA对照者。获取了基线心电图，并使用标准方案进行了心血管自主功能测试。
结果
镰状细胞患者的平均校正QT（QTc）显著高于对照组均值（P = 0.001）。同样，前者的平均QT离散度（QTcd）也高于后者（P = 0.001）。CAN患者的平均QTc长于自主神经功能正常的患者（461±26毫秒对411±23毫秒），P = 0.001（比值比为17.1，置信区间为3.48 - 83.71）。同样，CAN患者的QTcd高于心脏自主神经功能正常的患者（P = 0.001）。发现CAN与QTc和QTcd之间存在正相关（分别为r = 0.604，P = 0.001；r = 0.523，P = 0.001）。
结论
CAN是SCA患者QT参数异常的一个危险因素，两者都可能是心脏死亡的先兆。
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