摘要
目的分析获得性免疫缺陷综合征(AIDS)患者心电图临床特征。方法收集2011年1月至2013年12月在广西艾滋病临床治疗中心就诊的AIDS患者437例作为观察组,并选取南宁市第四人民医院广西艾滋病临床治疗中心时期413例健康体检者作为对照组。对两组对象的常规心电图进行对比分析;并按肝功能异常情况、CD_4^+T淋巴细胞计数[Ⅰ级(214例)、Ⅱ级(149例)和Ⅲ级(74例)]、血清白蛋白(异常)情况分成各亚组[血清白蛋白减少组(313例)和血清白蛋白正常组(124例)],对各亚组患者的心电图情况进行对比分析。结果 AIDS患者的心电图快心律失常率、慢心律失常率、左房室肥大率、右房室肥大率、ST-T改变率、Q-T间期延长率高于健康体检者[16.25%(71/437)比3.39%(14/413),9.38%(41/437)比1.69%(7/413),14.87%(65/437)比0.73%(3/413),1.37%(6/437)比0%,20.82%(91/437)比10.41%(43/423),14.19%(62/437)比0%],差异有统计学意义(P<0.01)。其中Ⅱ级和Ⅲ级AIDS患者快心律失常、左房室肥大、ST-T改变、Q-T间期延长率显著高于Ⅰ级[20.13%(30/149)、33.78%(25/74)比8.41%(18/214);12.75%(19/149)、28.38%(21/74)比11.68%(25/214);19.46%(29/149)、45.95%(34/74)比13.08%(28/214),14.77%(22/149)、24.32%(18/74)比11.21%(24/214)]。Ⅲ级AIDS患者快心律失常、左房室肥大、ST-T改变、Q-T间期延长率显著高于Ⅱ级,差异有统计学意义(P<0.05)。血清白蛋白减少组的快心律失常发生率显著高于血清白蛋白正常组[18.85%(59/313)比9.68%(12/124)],差异有统计学意义(P<0.05)。转氨酶升高组的快心律失常发生率显著高于转氨酶正常组[20.18%(46/228)比11.96%(25/209)],差异有统计学意义(P<0.05)。结论 AIDS患者血清蛋白、转氨酶、CD_4^+T淋巴细胞计数不同,其心电图异常表现也不同,原因可能为人类免疫缺陷病毒感染及并发症直接或间接损伤心脏引起。
Objective To analyze the clinical features correlated to abnormal electrocardiogram changes in patients with acquired immunodeficianey syndrome（AIDS）. Methods Collected from Jan. 2011 to Dec. 2013,437 AIDS patients in Guangxi AIDS Clinical Treatment Center for treatment were included as an observation group,and 413 cases of healthy people from the Fourth People＇s Hospital of Guangxi Nanning City AIDS Clinical Treatment Center during the same period were included as a control group. ECG analysis of the two groups were compared; and were further divided into subgroups according to the liver function abnormalities, CD4＋ T lymphocyte count [ stage Ⅰ （ 214 cases ） , stage Ⅱ （ 149 eases ） and stage m （ 74 cases） ] ,serum albumln（abnormal） case into subgroups[decreased serum albumin group （313 cases） and normal serum albumin （ 124 cases） ] , each ECG of the sub-groups were compared. Results The abnormal ECG, fast arrhythmia rate, slow arrhythmia rate, the rate of left atrioventrieular hypertrephy, the rate of right atrioventricular hypertrophy, ST-T changes rate, QT prolongation rate of AIDS patients were higher than the healthy subjects[16. 25% （71/437） vs 3.39% （14/413） ,9.38% （41/437） vs 1.69% （7/413） ,14. 87% （65/437） vs 0.73% （3/413）,1.37% （6/437） vs 0% ,20.82% （91/437） vs 10.41% （43/423）, 14. 19% （62/437） vs 0% ] ,the differences were statistically significant （P 〈0. 01 ）. Faster arrhythmia, left atriovantricular hypertrophy, ST-T changes, QT prolongation rate in Ⅱ stage and m stage AIDS patients were significantly higher than I stage [20. 13% （30/149） ,33.78% （25/74） vs 8.41% （18/214） ; 12.75% （19/149） ,28.38% （21/74） vs 11.68% （25/214） ;19.46% （29/149） ,45.95% （34/74） vs 13.08% （28/214）, 14.77 % （ 22/149 ） ,24.32% （ 18/74 ） vs 11.21% （ 24/214 ） ], faster archythmia, left atfioventricular hypertrophy, ST-T changes, QT prolongation of stage Ⅲ AIDS patients were higher than stage＇
出处
《医学综述》
2016年第13期2627-2629,2636,共4页
Medical Recapitulate
