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肝硬化中的Q-T间期延长。原位肝移植后的可逆性。

Q-T interval prolongation in liver cirrhosis. Reversibility after orthotopic liver transplantation.

作者信息

Finucci G, Lunardi F, Sacerdoti D, Volpin R, Bortoluzzi A, Bombonato G, Angeli P, Gatta A

机构信息

Department of Clinical Medicine, University of Padua, Italy.

出版信息

Jpn Heart J. 1998 May;39(3):321-9. doi: 10.1536/ihj.39.321.

DOI:10.1536/ihj.39.321
PMID:9711183
Abstract

The aim of this work was to study the prevalence of Q-T prolongation in patients with liver cirrhosis and the modifications of the Q-T interval after liver transplantation. Q-T interval corrected for heart rate (QTc) and dispersion of Q-T interval were evaluated in 75 cirrhotic patients and in 24 controls by means of a 12-lead electrocardiogram. In addition, 15 patients were evaluated before and after liver transplantation. Forty-five patients (60%) had a prolonged Q-Tc. Compared with controls, both patients with alcoholic and non alcoholic cirrhosis had increased Q-Tc (414 +/- 28 msec1/2, 463 +/- 31 and 444 +/- 32 respectively; p < 0.001 and < 0.001); Q-Tc was significantly higher in alcoholic than in non-alcoholic cirrhosis (p < 0.02). Q-T dispersion was normal in cirrhotics. No correlation was found between Q-Tc interval and severity of the cirrhosis, haemodynamic variables (stroke volume, cardiac output) and s-calcium and potassium concentrations. After transplantation, Q-Tc decreased significantly (415 +/- 26 msec1/2 vs 449 +/- 31; p < 0.0001) returning to the values of the normal subjects, but no modification of the Q-T dispersion was observed. These data show that 1) prolongation of Q-T interval is frequent in cirrhosis, being higher in alcoholic than in non-alcoholic cirrhosis, 2) is not related to the severity of the disease, and 3) is reversible after transplantation.

摘要

这项研究的目的是探讨肝硬化患者Q-T间期延长的发生率以及肝移植后Q-T间期的变化。通过12导联心电图对75例肝硬化患者和24例对照者的心率校正Q-T间期(QTc)及Q-T间期离散度进行评估。此外,对15例患者在肝移植前后进行了评估。45例患者(60%)存在QTc延长。与对照组相比,酒精性和非酒精性肝硬化患者的QTc均升高(分别为414±28毫秒1/2、463±31和444±32;p<0.001和<0.001);酒精性肝硬化患者的QTc显著高于非酒精性肝硬化患者(p<0.02)。肝硬化患者的Q-T离散度正常。未发现QTc间期与肝硬化严重程度、血流动力学变量(每搏输出量、心输出量)以及血清钙和钾浓度之间存在相关性。移植后,QTc显著降低(415±26毫秒1/2对449±31;p<0.0001),恢复到正常受试者的值,但未观察到Q-T离散度的改变。这些数据表明:1)肝硬化患者中Q-T间期延长很常见,酒精性肝硬化患者高于非酒精性肝硬化患者;2)与疾病严重程度无关;3)移植后可逆转。

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