摘要
目的探讨长QT综合征(LQTS)患者T波峰-末(Tp-e)间期及Tp-e/QT与室性心律失常发作的相关性。方法回顾性分析确诊为LQTS的14个家系,对家系成员的临床情况进行综合分析。记录先证者(包括发作期和稳定期)、无症状者及家族中正常者共149例成员的同步12导联心电图,测量计算心电图校正QT(QTc)间期、Tp-e间期以及Tp-e/QT,并进行比较。结果先症者发病年龄19.2岁。在20岁以前发病者占57.1%。患者以女性居多,均以晕厥为主要发病表现。运动及情绪激动诱发12例,休息或睡眠时发生2例。先证者和无症状患者的QTc间期、Tp-e间期及Tp-e/QT显著大于家系其他正常成员(P≤0.05)。先证者发作期的Tp-e间期及Tp-e/QT大于稳定期(P≤0.05)。结论伴有晕厥的长QT综合征患者Tp-e间期延长,Tp-e/QT增大提示增加跨壁复极离散度与恶性室性心律失常发生相关,动态观察LQTS患者心电图改变可能成为预测LQTS恶性心律失常发生危险的临床指标。
Objective To study the correlation between the characteristic of the interval from the peak to the end of the electrocardiographic T wave （Tp-e） and Tp-e/QT and the ventricular arrhythmogenesis in long QT syndrome （LQTS） pa- tients. Methods Fourteen families of LQTS were collected in this study. The clinical manifestations of all 14 families were analyzed. 12 leads ECG of all 149 family members were recorded, including the probands （ both onset and none-onset period, asymptomatic patients, as well as normal persons in the 14 families. The corrected QT（QTc） interval, Tpeak-end （Tp-e） interval and Tp-e/QT ratio of electrocardiograph were measured. Results The age distribution for the first Tdp at- tack of probands was 19.2 year old, and 57.1% of patients had their first attack before the age of 20. The ratio of male to fe- male is around 3 to 11, and the most prominent symptom of 14 patients was syncope,of whom 12 patients were triggered by e- motion or exercise and 2 patients started at rest or sleep. Compared with the normal persons in this 14 families, the mean QTc interval, Tp-e interval and Tp-e/QT ratio increased significantly in proband and asymptomatic patients （P 〈 0.05 ）. Also, comparing the Tp-e interval and Tp-e/QT ratio in proband of Tdp onset and none-onset groups, it appeared signifi- cant difference （ P 〈 0.05 ）. Conclusion The amplification of the Tp-e interval and Tp-e/QT ratio could suggest that in- crease the transmural dispersion of repolarization in congenital LQTS patients with syncope and is associated with malignant ventricular arrhythmias. Dynamic change of both Tp-e interval and Tp-e/QT ratio could serve as a clinical index to predict if syncope and Tdp occur in LQTS.
出处
《中国心脏起搏与心电生理杂志》
北大核心
2010年第5期411-412,共2页
Chinese Journal of Cardiac Pacing and Electrophysiology
基金
国家自然科学基金资助项目(项目编号:30870659
30971221)
关键词
心血管病学
长QT综合征
心电图
T波峰-末间期
跨壁复极离散度
Cardiology
Long QT syndrome
Electrocardiogram
Tpeak-end interval
Transmural dispersion of repolarization
