摘要
目的 观察儿童先天性长QT综合征（LQTS）患者进行运动试验时QT间期的变化。方法 因QT间期延长而行运动平板试验的患儿共33例入选本研究，按照1993年Schwartz等的LQTS诊断标准的计分分值分为两组：LQTS组：总计分值为4分及以上的患者17例，男13例、女4例，年龄11．6±3．7岁；可疑组：评分为1．5—3．5分的患者16例，男9例、女7例，年龄13．8±4．2岁。另选行运动试验的18例正常儿童作为对照组，男11例、女7例，年龄12．4±3．1岁。记录整个运动试验中和恢复期的心电图，观察QT间期和心率的变化，记录并计算恢复期第1，2，4，6 min QT间期与运动过程中同心率时QT间期的差值（AQT）。结果 三组患者在运动中随着心率的增加，QT间期逐渐缩短。运动恢复期，随着心率的减慢，三组的QT间期也逐渐延长，但LQTS组恢复期QT间期却显著短于运动过程中处于同心率时的QT间期。LQTS组在恢复期1，2，4min的AQT值均显著大于其它两组（P均〈0．05）。LQTS组在QT间期与心动周期的关系图上呈现明显的“QT滞后环”。结论 儿童LQTS患者运动试验恢复期与运动过程中相比，QT间期的变化明显滞后于心率的变化。
Objective To observe the QT interval changing during exercise testing in patients with children＇s long QT syndrome（ LQTS）, and to explore the new diagnosis methods of LQTS. Methods The subjects were divided into 3 groups based on the diagnosis criteria of LQTS by Schwarts in 1993 ： LQTS group（ score ≥4, n = 17 ）, Suspected group（ 1.5 ≤ score ≤3.5, n = 16）, and Normal control group（ score ≤ 1.5, n = 18 ）. The average age of all study population was 12.3 ± 5.8 years old. All subjects were underwent tread mill exercise testing. Electrocardiograph during exercise testing and recovery period was recorded. QT interval and heart rate changing during whole exercise testing period were calculated. The QT interval at 1, 2, 4, 6 minute into recovery subtract from the QT interval（AQT） at a similar heart rate during exercise were calculated. Results In all three groups, QT interval shortened with the increasing of heart rate during exercise testing and prolonged with the decreasing of heart rate during recovery. In LQTS group, QT interval during recovery was significantly shorter than that of QT at a similar heart rate during exercise. AQT at 1,2, 4minute into recovery were significantly greater in LQTS group than that of the other groups. There was no significantAQT differences between the suspected group and control group. During the early recovery phase in LQTS group, the QT interval remained shortened despite a decelerating heart rate, forming a hysteresis ＂loop＂ in the curve relating the QT interval to the cycle length. Conclusion In children＇s LQTS, there is significant QT hysteresis loop in the relation of QT interval with heart rate during recovery of exercise testing.
出处
《中国心脏起搏与心电生理杂志》
2006年第1期28-30,共3页
Chinese Journal of Cardiac Pacing and Electrophysiology
