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肝硬化患者的QT间期延长

Q-T Interval Prolongation in Patients with Liver Cirrhosis.

作者信息

Țieranu E, Donoiu I, Istrătoaie O, Găman A E, Țieranu L M, Gheonea D I, Ciurea T

机构信息

Department of Cardiology, University of Medicine and Pharmacy, Craiova, Romania.

Department of Bacteriology-Virology-Parasitology, University of Medicine and Pharmacy of Craiova, Romania.

出版信息

Curr Health Sci J. 2018 Jul-Sep;44(3):274-279. doi: 10.12865/CHSJ.44.03.11. Epub 2018 Jul 15.

Abstract

Liver cirrhosis (LC) is the end stage of chronic liver disease characterized by the appearance of extensive fibrosis and regeneration nodes associated with hepatocyte necrosis in liver but also by the reshuffling of hepatic architecture. The triad consisting of hepatic parenchymal necrosis, regeneration and scarring is always present regardless of the type of clinical manifestation. The Child-Pugh-Turcotte classification dates back more than 30 years and has been widely used in diagnosing and assessing the severity of liver cirrhosis. This is preferred due to a low degree of complexity and a good predictive value. Prolongation of the QT interval on the electrocardiogram is common, with a prevalence exceeding 60% in patients with advanced stage of cirrhosis. In these cases, beta blockers and antiarrhythmics should be avoided or used with caution and with close QT interval monitoring. Changes in heart rate and Q-T interval are new entities in cirrhosis complications. A prolonged Q-T interval in chronic liver disease could lead to ventricular arrhythmias and sudden death. There is no report on heart rate and Q-T interval disorders in our area.

摘要

肝硬化(LC)是慢性肝病的终末期,其特征是肝脏出现广泛纤维化和与肝细胞坏死相关的再生结节,同时肝脏结构也发生重塑。无论临床表现类型如何,肝实质坏死、再生和瘢痕形成这三者总是存在的。Child-Pugh-Turcotte分类法可追溯到30多年前,已广泛用于诊断和评估肝硬化的严重程度。因其复杂度低且预测价值良好,所以更受青睐。心电图上QT间期延长很常见,在晚期肝硬化患者中的患病率超过60%。在这些情况下,应避免使用β受体阻滞剂和抗心律失常药物,或谨慎使用并密切监测QT间期。心率和Q-T间期的变化是肝硬化并发症中的新情况。慢性肝病中QT间期延长可能导致室性心律失常和猝死。我们地区尚无关于心率和Q-T间期紊乱的报告。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88cc/6311219/e9ade6b16e42/CHSJ-44-03-11-fig1.jpg

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