中国血液净化 ›› 2015, Vol. 14 ›› Issue (07): 418-421.doi: 10.3969/j.issn.1671-4091.2015.07.009

• 临床研究 • 上一篇    下一篇

主动脉弓钙化的血液透析患者心电图Q-T离散度的改变

吕路,黄华,桓文穆,黄培华,曾红华   

  1. 广东药学院附属第一医院肾内科
  • 收稿日期:2014-12-31 修回日期:2015-05-11 出版日期:2015-07-12 发布日期:2015-07-12
  • 通讯作者: 吕路 emailoflvlu@sina.com E-mail:emailoflvlu@sina.com
  • 基金资助:

    广东省自然科学基金(06032273)

Changes of QT dispersion on electrocardiogram in hemodialysis patients with aortic arch calcification

  • Received:2014-12-31 Revised:2015-05-11 Online:2015-07-12 Published:2015-07-12

摘要: 【摘要】目的观察血液透析患者的主动脉弓钙化(AAC),分析具有AAC 的血液透析患者心电图QT 离散度(QTd)的改变。方法收集维持性血液透析患者的临床资料,据胸部X 线片判断有无AAC,检测QTd和校正的QT 离散度(QTcd),彩色多普勒超声心动图测量左心室射血分数(EF)、二尖瓣舒张早期血流峰值和二尖瓣环舒张早期运动速度之比(E/E’)。结果97 例血液透析患者中60 例(61.9%)发现主动脉弓钙化,37 例(38.1%)未发现主动脉弓钙化。主动脉弓钙化组和非钙化组在年龄、糖尿病的比例、舒张压、脉压、血清白蛋白、iPTH 和心胸比有显著差异。钙化组的QTd(51.05±3.01ms)、QTcd(57.18±3.37ms)和E/E’(21.94±4.83)显著大于非钙化组的QTd(49.41±2.43ms)、QTcd(54.85±2.69ms)和E/E’(16.93± 4.15)(P<0.01)。钙化组的QTcd 和EF 呈显著负相关(r=-0.388,P=0.002),钙化组的QTcd 和E/E’呈显著正相关(r=0.473,P<0.001)。血液透析患者的QTd、QTcd 和年龄、iPTH、心胸比显著相关(P<0.01)。结论具有主动脉弓钙化的血液透析患者QTd、QTcd显著延长,其QTcd 和左心室功能显著相关。

关键词: 主动脉弓钙化, QT离散度, 血液透析

Abstract: 【Abstract】Objective To investigate the QT dispersion (QTd) in maintenance hemodialysis (MHD) patients with aortic arch calcification (AAC). Methods Clinical data in MHD patients were collected, and chest radiography was used to detect AAC. Patients were then divided into two groups based on the presence or absence of AAC. Twelve-lead ECG was performed to measure QTd and corrected QTd (QTcd). Left ventricular ejection fraction (EF) and the ratio of mitral early diastolic peak flow and mitral annular early diastolic velocity (E/E’) were measured by echocardiography. Results A total of 97 MHD patients were included in this study. AAC was detected in 60 (61.9%) patients. There were significant differences between the two groups in age, prevalence of diabetes mellitus, diastolic blood pressure, pulse pressure, serum albumin, iPTH, and cardiothoracic ratio. Compared to the group without AAC, AAC group had significantly longer QTd(51.05±3.01 ms vs. 49.41±2.43 ms, P<0.01), QTcd (57.18±3.37 ms vs. 54.85±2.69 ms, P<0.01) and higher E/E’(21.94 ± 4.83 vs. 16.93 ± 4.15,P<0.01). In AAC group, QTcd was negatively correlated with EF (r= -0.388, P=0.002) and was positively correlated with E/E’(r=0.473, P<0.001). QTd and QTcd were significantly correlated with age, iPTH and cardiothoracic ratio (P<0.01) in MHD patients. Conclusions In MHD patients with AAC, QTd and QTcd were prolonged, and their QTcd was significantly correlated to left ventricular function.

Key words: aortic arch calcification, QT dispersion, hemodialysis