乙型肝炎后肝硬化患者Q-Tc间期的变化及其临床意义

Changes of Q-Tc interval in patients with posthepatitis B cirrhosis and its clinical significance

  • 摘要:
      目的  分析乙型肝炎后肝硬化患者心电图Q-Tc的变化及其相关因素。
      方法  回顾性分析乙型病毒性肝炎肝硬化患者80例(肝硬化组)的临床资料。比较肝硬化组和30例慢性乙肝患者(对照组)一般资料。分析心电图Q-Tc间期的变化;分析Child-Pugh评分、分级与肝硬化程度的关系。
      结果  肝硬化组患者的血清钠、血清钙、血清白蛋白、血红蛋白、血小板低于对照组,血清胆红素、谷草转氨酶高于对照组,凝血酶原时间长于对照组,差异有统计学意义(P < 0.05)。肝硬化组的心率高于对照组,Q-Tc间期长于对照组,差异有统计学意义(P < 0.05)。Q-Tc间期与Child-Pugh评分(r=0.38,P < 0.01)呈正相关,而与血清白蛋白(r=-0.31,P=0.006)、血红蛋白(r=-0.29,P=0.010)呈负相关;Child-Pugh评分是影响肝硬化患者心电图Q-Tc间期的独立相关因素。
      结论  肝硬化患者存在Q-Tc延长,且和Child-Pugh评分相关。检测Q-Tc间期变化,对了解肝硬化患者病情严重程度有临床指导意义。

     

    Abstract:
      Objective  To analyze the changes of Q-Tc in electrocardiogram and its related factors in patients with posthepatitis B cirrhosis.
      Methods  The clinical data of 80 patients with viral hepatitis B cirrhosis (cirrhosis group) was retrospectively analyzed. The general data of the cirrhosis group and 30 chronic hepatitis B patients (control group) was compared. The changes of electrocardiogram in Q-Tc interval were analyzed. The relationships between Child-Pugh score, grade and degree of cirrhosis was analyzed.
      Results  The levels of serum sodium, serum calcium, serum albumin, hemoglobin and platelet in the cirrhosis group were significantly lower, while the levels of serum bilirubin and aspartate aminotransferase were significantly higher, and prothrombin time was significantly longer than that in the control group (P < 0.05). The heart rate in the cirrhosis group was significantly higner, and the Q-Tc interval was significantly longer than that in the control group (P < 0.05). The Q-Tc interval was positively correlated with Child-Pugh score (r=0.38, P < 0.01), but negatively correlated with serum albumin (r=-0.31, P=0.006) and hemoglobin (r=-0.29, P=0.010); Child-pugh score was an independent correlation factor affecting the electrocardiogram Q-Tc interval in patients with cirrhosis.
      Conclusion  Q-Tc is prolonged in patients with cirrhosis and it is correlated with Child-Pugh score. The detection of Q-Tc interval changes has clinical guiding significance for knowing the severity of cirrhosis.

     

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