Lengyel C, Várkonyi T, Boda K, Fazekas T
I. Belgyógyászati Klinika, Szent-Györgyi Albert Orvostudományi Egyetem, Szeged.
Orv Hetil. 1997 Feb 9;138(6):337-41.
The QT dispersion, measured as the interlead variability of QT interval (QTd = QTmax-QTmin), reflects the spatial inhomogeneity of ventricular repolarization times. The authors studied QTd and heart rate-corrected QTd (QTc-d) in 81 patients with diabetes mellitus (IDDM: 39, NIDDM: 42) using Bazett's formula; 20 non-diabetic subjects acted as controls (means +/- SD). QTd (43 +/- 17 ms) and QT c-d (52 +/- 20 ms) were increased (p < 0.05) as compared to the control values (QTd = 32 +/- 17 and, QTc-d = 35 +/- 17 ms, respectively). A significant difference was also observed in QTc-d if the two diabetic groups were compared to the control separately (p < 0.05). Moreover, comparison of the diabetic groups (IDDM vs NIDDM) revealed that type I diabetes mellitus is accompanied by a more pronounced spatial dispersion of ventricular reporlarization (QTd = 49 +/- 16, and QTc-d = 59 +/- 19 ms) as compared to NIDDM (QTd = 38 +/- 16, QTc-d = 46 +/- 20 ms [p < 0.01]). The hypothesis that increased QTd/QTc-d is truly a predictive marker of sudden arrhythmic cardiac death in patients with diabetes mellitus needs further clinical investigation.
QT离散度通过导联间QT间期变异性来测量（QTd = QTmax - QTmin），反映心室复极时间的空间不均匀性。作者使用Bazett公式对81例糖尿病患者（胰岛素依赖型糖尿病：39例，非胰岛素依赖型糖尿病：42例）的QT离散度和心率校正QT离散度（QTc-d）进行了研究；20名非糖尿病受试者作为对照（均值±标准差）。与对照值（QTd分别为32±17和QTc-d为35±17 ms）相比，QTd（43±17 ms）和QTc-d（52±20 ms）升高（p < 0.05）。若将两个糖尿病组分别与对照组比较，QTc-d也存在显著差异（p < 0.05）。此外，糖尿病组之间（胰岛素依赖型糖尿病与非胰岛素依赖型糖尿病）的比较显示，与非胰岛素依赖型糖尿病（QTd = 38±16，QTc-d = 46±20 ms [p < 0.01]）相比，I型糖尿病伴有更明显的心室复极空间离散度（QTd = 49±16，QTc-d = 59±19 ms）。QTd/QTc-d升高是糖尿病患者心律失常性心脏性猝死真正预测指标这一假设需要进一步的临床研究。
