目的分析肺癌患者放疗后心电图异常情况及其影响因素。方法选取2015年4月至2017年5月于杭州师范大学附属医院行调强放射治疗的肺癌患者93例,比较治疗前后24h动态心电图监测到的心电图变化和异常,采用logistic回归分析法对可能引起心电...目的分析肺癌患者放疗后心电图异常情况及其影响因素。方法选取2015年4月至2017年5月于杭州师范大学附属医院行调强放射治疗的肺癌患者93例,比较治疗前后24h动态心电图监测到的心电图变化和异常,采用logistic回归分析法对可能引起心电图异常的因素进行分析。结果患者治疗后窦性心律失常发生率与治疗前比较,差异无统计学意义(P>0.05),房性和室性心律失常、传导阻滞、ST-T段改变及心电图异常总发生率较治疗前明显升高(均P<0.05);log is tic回归分析显示,性别、40Gy以上剂量照射的心脏体积所占比是影响患者心电图异常的主要因素(均P<0.05)。结论肺癌放射治疗可导致心电异常,受照射心脏体积是主要影响因素。展开更多
Background Electrocardiographic （ECG） changes occurring during the course of acute brain injury （ABI） have been described frequently, but their significances remain uncertain. The present study was designed to inv...Background Electrocardiographic （ECG） changes occurring during the course of acute brain injury （ABI） have been described frequently, but their significances remain uncertain. The present study was designed to investigate the relation of ECG abnormalities to outcome in the patients with ABI. Methods We performed a retrospective, observational study on the ABI patients admitted to the Department of Neurosurgery of the Beijing Tiantan Hospital between December 2005 and December 2007. All the patients accepted 12-lead electrocardiographic examination within 24 hours after injury, then divided into three groups according to the Glasgow coma score （GCS）. In-hospital mortality and one-month outcome assessed by the Glasgow outcome score （GOS） were investigated. Results Of 335 ABI patients （mean ages 32.4 years）, 246 patients （73.4%） had abnormal ECGs. The most common abnormality was ST-T changes （41.5%）, followed by sinus tachycardia （23.6%）. ECG changes had a significant association with the severity and outcome. Logistic regression analysis showed the presence of ST-T changes （OR 2.587, 95%C/1.009 to 6.629, P=0.048） and QT dispersion prolongation （OR 4.656, 95%C/1.956 to 11.082, P=0.001） significantly associated with short outcomes. Conclusions ABI can lead to myocardial damage and ECG changes had a significant association with the severity. ST-T changes and QT dispersion prolongation were the independent prognosis factors for the negative outcome of ABI patients.展开更多
目的了解HIV感染者的血清白蛋白(albumin,ALB)、球蛋白(globulin,GLB)和白球蛋白比例(albumin to globulin ratio,AGR)与心电图(electrocardiograph,ECG)异常之间的关联性。方法采用横断面研究的方法,选自2017-2018年“HIV与衰老相关疾...目的了解HIV感染者的血清白蛋白(albumin,ALB)、球蛋白(globulin,GLB)和白球蛋白比例(albumin to globulin ratio,AGR)与心电图(electrocardiograph,ECG)异常之间的关联性。方法采用横断面研究的方法,选自2017-2018年“HIV与衰老相关疾病前瞻性队列研究”基线数据,纳入1788例18~<75岁的HIV感染者进行分析。低ALB定义为血清ALB<38 g/L,高GLB定义为血清GLB>35 g/L,低AGR定义为AGR≤1.5,ECG异常定义为出现任何心电图结果异常。采用多因素logistic回归分析模型分析ALB、GLB和AGR与ECG异常的关联性。结果ECG异常、快心律失常、窦性心动过速、ST/T段异常和左室高电压的患病率分别为41.16%(736/1788)、9.00%(161/1788)、6.15%(110/1788)、14.88%(266/1788)和5.26%(94/1788)。3.08%(55/1788)的研究对象为低ALB,37.19%(665/1788)为高GLB,65.49%(1171/1788)为低AGR。多因素logistic回归分析模型结果显示,调整年龄、性别、ALT、AST、BMI、高血压、HIV特异性变量等之后,低ALB是窦性心动过速(aOR=4.89,95%CI:1.96~12.20,P=0.001)和快心律失常(aOR=3.24,95%CI:1.50~6.99,P=0.003)的独立影响因素。高GLB是窦性心动过速的独立影响因素(aOR=1.66,95%CI:1.00~2.74,P=0.049),而与其他ECG异常差异均无统计学意义(均P>0.05)。AGR降低与窦性心动过速差异均无统计学意义(均P>0.05)。结论HIV感染者存在较高比例的白球蛋白水平异常。低ALB和高GLB是窦性心动过速的独立危险因素,提示异常的白球蛋白水平可能侧面反映较高的炎症反应状态,可为预测该人群心血管疾病的发病风险提供新的线索和依据,但其中的因果关系和机制需要进一步研究。展开更多
目的蛛网膜下腔出血(SAH)患者心电图异常频率高,研究确定任何特定的心电图异常是否与住院患者的不良结果相关。方法该研究从270例非创伤性SAH患者中选择145例作为研究对象。对所有SAH发病72h内的患者进行标准的体表心电图检查。根据出...目的蛛网膜下腔出血(SAH)患者心电图异常频率高,研究确定任何特定的心电图异常是否与住院患者的不良结果相关。方法该研究从270例非创伤性SAH患者中选择145例作为研究对象。对所有SAH发病72h内的患者进行标准的体表心电图检查。根据出院时住院死亡率或神经功能恶化程度(世界神经外科医师联合会,WFNS分级),将所有患者分为预后好组和预后不良组。结果不良结果(n=29)患者心率明显升高(93.52±22.23 vs 78.42±18,p<0.01),QTC延长(458.17±44.88 vs 436.89±43.46,p=0.027)。心电图异常的发生率较高,包括ST段(90%对44%,p<0.01)和左室肥大(28%对10%,p<0.03)。多重logistic回归发现ST异常(优势比2.811;95%可信区间1.014-7.789;p<0.05)、心率异常(优势比4.207;95%可信区间1.063-16.651;p<0.05)和WFNS分级(优势比4.741;95%可信区间1.949~11.531;p=0.001)是与住院不良预后相关的显著独立变量。结论ST段压低或抬高以及入院时心率异常,与住院SAH患者临床预后不良的风险增加密切相关。展开更多
文摘目的分析肺癌患者放疗后心电图异常情况及其影响因素。方法选取2015年4月至2017年5月于杭州师范大学附属医院行调强放射治疗的肺癌患者93例,比较治疗前后24h动态心电图监测到的心电图变化和异常,采用logistic回归分析法对可能引起心电图异常的因素进行分析。结果患者治疗后窦性心律失常发生率与治疗前比较,差异无统计学意义(P>0.05),房性和室性心律失常、传导阻滞、ST-T段改变及心电图异常总发生率较治疗前明显升高(均P<0.05);log is tic回归分析显示,性别、40Gy以上剂量照射的心脏体积所占比是影响患者心电图异常的主要因素(均P<0.05)。结论肺癌放射治疗可导致心电异常,受照射心脏体积是主要影响因素。
基金This study was supported by the National Natural Science Foundation of China （No. C03030201）
文摘Background Electrocardiographic （ECG） changes occurring during the course of acute brain injury （ABI） have been described frequently, but their significances remain uncertain. The present study was designed to investigate the relation of ECG abnormalities to outcome in the patients with ABI. Methods We performed a retrospective, observational study on the ABI patients admitted to the Department of Neurosurgery of the Beijing Tiantan Hospital between December 2005 and December 2007. All the patients accepted 12-lead electrocardiographic examination within 24 hours after injury, then divided into three groups according to the Glasgow coma score （GCS）. In-hospital mortality and one-month outcome assessed by the Glasgow outcome score （GOS） were investigated. Results Of 335 ABI patients （mean ages 32.4 years）, 246 patients （73.4%） had abnormal ECGs. The most common abnormality was ST-T changes （41.5%）, followed by sinus tachycardia （23.6%）. ECG changes had a significant association with the severity and outcome. Logistic regression analysis showed the presence of ST-T changes （OR 2.587, 95%C/1.009 to 6.629, P=0.048） and QT dispersion prolongation （OR 4.656, 95%C/1.956 to 11.082, P=0.001） significantly associated with short outcomes. Conclusions ABI can lead to myocardial damage and ECG changes had a significant association with the severity. ST-T changes and QT dispersion prolongation were the independent prognosis factors for the negative outcome of ABI patients.
文摘目的蛛网膜下腔出血(SAH)患者心电图异常频率高,研究确定任何特定的心电图异常是否与住院患者的不良结果相关。方法该研究从270例非创伤性SAH患者中选择145例作为研究对象。对所有SAH发病72h内的患者进行标准的体表心电图检查。根据出院时住院死亡率或神经功能恶化程度(世界神经外科医师联合会,WFNS分级),将所有患者分为预后好组和预后不良组。结果不良结果(n=29)患者心率明显升高(93.52±22.23 vs 78.42±18,p<0.01),QTC延长(458.17±44.88 vs 436.89±43.46,p=0.027)。心电图异常的发生率较高,包括ST段(90%对44%,p<0.01)和左室肥大(28%对10%,p<0.03)。多重logistic回归发现ST异常(优势比2.811;95%可信区间1.014-7.789;p<0.05)、心率异常(优势比4.207;95%可信区间1.063-16.651;p<0.05)和WFNS分级(优势比4.741;95%可信区间1.949~11.531;p=0.001)是与住院不良预后相关的显著独立变量。结论ST段压低或抬高以及入院时心率异常,与住院SAH患者临床预后不良的风险增加密切相关。
