Ou Min, Tian Yin, Zhuang Guoqiang, Peng Ying
Department of Cardiovascular Medicine, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China.
Department of Gastroenterology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China.
Med Clin (Barc). 2021 Jan 22;156(2):68-75. doi: 10.1016/j.medcli.2020.06.059. Epub 2020 Dec 9.
QTc interval prolongation is common in patients with liver cirrhosis. Cirrhotic patients suffering from complications could also prolong QT interval. We aimed to explore the role of QTc interval prolongation in cirrhotic patients with upper gastrointestinal bleeding (UGIB). Overall, 167 patients were analyzed. QTc interval prolongation presented in 111 patients (66.5%). One hundred and seven patients (64.1%) suffered from acute UGIB. Results showed that RBC, Hb, ALB and calcium (Ca) were significantly lower, and DBIL, GGT, APTT, Child-Pugh score, MELD score and ALBI score were significantly higher in the prolongation group than those without QTc prolongation. AUROC of QTc was .699 (95%CI: .623-.768). In the acute UGIB subgroup, AUROC of QTc was .478 (95%CI: .347-.611). In the HBV subgroup, AUROC of QTc was .722 (95%CI: .616-.812). QTc interval prolongation was prevalent in cirrhotic patients with UGIB and correlated with liver dysfunction. QTc might not be a valid predictor of in-hospital mortality.
QTc间期延长在肝硬化患者中很常见。患有并发症的肝硬化患者也可能出现QT间期延长。我们旨在探讨QTc间期延长在肝硬化合并上消化道出血（UGIB）患者中的作用。总共分析了167例患者。111例患者（66.5%）出现QTc间期延长。107例患者（64.1%）发生急性UGIB。结果显示，QTc间期延长组的红细胞（RBC）、血红蛋白（Hb）、白蛋白（ALB）和钙（Ca）显著降低，直接胆红素（DBIL）、γ-谷氨酰转肽酶（GGT）、活化部分凝血活酶时间（APTT）、Child-Pugh评分、终末期肝病模型（MELD）评分和白蛋白-胆红素（ALBI）评分显著高于未出现QTc间期延长的患者。QTc的受试者工作特征曲线下面积（AUROC）为0.699（95%可信区间：0.623 - 0.768）。在急性UGIB亚组中，QTc的AUROC为0.478（95%可信区间：0.347 - 0.611）。在乙型肝炎病毒（HBV）亚组中，QTc的AUROC为0.722（95%可信区间：0.616 - 0.812）。QTc间期延长在肝硬化合并UGIB患者中很普遍，且与肝功能障碍相关。QTc可能不是住院死亡率的有效预测指标。
