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住院慢性肾脏病患者获得性长 QT 综合征的患病率及危险因素。

Prevalence and risk factors of acquired long QT syndrome in hospitalized patients with chronic kidney disease.

机构信息

First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

出版信息

J Investig Med. 2019 Feb;67(2):289-294. doi: 10.1136/jim-2018-000798. Epub 2018 Oct 26.

DOI:10.1136/jim-2018-000798
PMID:30367011
Abstract

Patients with chronic kidney disease (CKD) have a high risk of fatal arrhythmias. The extended severe corrected QT (QTc) interval is a hallmark of ventricular arrhythmias and sudden cardiac death. The objective of this study was to evaluate the prevalence of acquired long QT syndrome (aLQTS) in hospitalized patients with CKD and search for potential risk factors to improve clinical risk stratification in patients with CKD. Information about patients with CKD was retrospectively collected in our hospital between January 2013 and June 2017. The prevalence of aLQTS in different stages of CKD was evaluated. The common risk factors for QTc prolongation in patients with CKD were compiled, and multivariable logistic regression analysis was used to evaluate how each factor was related to aLQTS in CKD. A total of 804 patients with CKD (299 females, 37.2%) participated in our study. The prevalence of aLQTS among all 804 patients was 56.97%, and the prevalence of QTc prolongation (>500 ms) was 10.07%. Among the elderly, impaired kidney function, hemodialysis, low serum potassium and low left ventricular ejection fraction (LVEF) were associated with QTc prolongation in patients with CKD. The prevalence of aLQTS is much higher and increases with the decline of kidney function in hospitalized patients with CKD, which is related to older age, impaired kidney function, hemodialysis, serum potassium and low LVEF.

摘要

患有慢性肾病(CKD)的患者有发生致命性心律失常的高风险。延长的严重校正 QT(QTc)间期是室性心律失常和心源性猝死的标志。本研究的目的是评估住院 CKD 患者获得性长 QT 综合征(aLQTS)的患病率,并寻找潜在的危险因素,以改善 CKD 患者的临床风险分层。我们在 2013 年 1 月至 2017 年 6 月期间在我院回顾性收集了 CKD 患者的信息。评估了不同 CKD 分期患者中 aLQTS 的患病率。总结了 CKD 患者 QTc 延长的常见危险因素,并进行多变量逻辑回归分析,以评估每个因素与 CKD 中 aLQTS 的关系。共有 804 例 CKD 患者(女性 299 例,占 37.2%)参与了我们的研究。804 例患者中 aLQTS 的患病率为 56.97%,QTc 延长(>500 ms)的患病率为 10.07%。在老年人中,肾功能受损、血液透析、低血钾和低左心室射血分数(LVEF)与 CKD 患者的 QTc 延长有关。aLQTS 的患病率较高,且随着住院 CKD 患者肾功能的下降而增加,与年龄较大、肾功能受损、血液透析、血清钾和低 LVEF 有关。

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