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目的 评价Q-T间期离散度(Q-Td)、校正的Q-T离散度(Q-Tcd)对煤工尘肺(CWP)患者发生严重室性心律失常的预测价值,并观察CWP患者严重室性心律失常与Q-Td、Q-Tcd的关系。方法依丹麦ABL-4血气分析仪所测100例CWP低氧血症程度和Lown’s室性心律失常分级进行分析,并以40例煤矿工人为对照。结果 (1)对照组Q-Td、Q-Tcd均未见因年龄产生的明显差异。(2)CWP低氧血症患者中,PaO2≤60 mmHg组Q-Td为(59.9±21.7)ms,Q-Tcd为(72.91±25.25)ms,较PaO2>60 mm Hg组[Q-Td为(51.53±21)ms,Q-Tcd为(57.8±18)ms]明显延长,差异有统计学意义(P<0.05);患者的Q-Td与Q-Tcd延长,随患者低氧血症程度进展而加重。(3)Q-Td、Q-Tcd延长致CWP患者室性心律失常级别增加。严重室性心律失常组Q-Td为(79.28±15.27)ms、Q-Tcd为(84.39±14.2)ms,比轻级室性心律失常组(L1-2)明显延长,差异有统计学意义(P<0.05)。Q-Td>79ms以上者中,63.33%的发生严重室性心律失常。结论 Q-Td、Q-Tcd值越大者,严重室性心律失常发生率越高。Q-Td明显延长可能预告严重室性心律失常的发生。
Objective To evaluate the predictive value of QT dispersion (Q-Td) and corrected QT dispersion (Q-Tcd) for severe ventricular arrhythmia in CWP patients and to observe the effects of severe ventricular arrhythmias And Q-Td, Q-Tcd relationship. Methods According to the Danish ABL-4 blood gas analyzer measured 100 cases of CWP hypoxemia and Lown’s ventricular arrhythmia grading analysis, and 40 cases of coal mine workers as a control. Results (1) There was no significant difference in Q-Td and Q-Tcd in the control group due to age. (2) The Q-Td was (59.9 ± 21.7) ms and the Q-Tcd was (72.91 ± 25.25) ms in PaO2≤60 mmHg group compared with PaO2> 60 mm Hg group [Q-Td was (51.53 ± 21) ms and Q-Tcd was (57.8 ± 18) ms], the difference was statistically significant (P <0.05). The Q-Td and Q-Tcd were prolonged in patients with hypoxemia Progress and aggravate. (3) The increase of ventricular arrhythmia in CWP patients caused by Q-Td and Q-Tcd prolongation. The Q-Td was (79.28 ± 15.27) ms and the Q-Tcd was (84.39 ± 14.2) ms in patients with severe ventricular arrhythmias, which was significantly longer than that in patients with mild ventricular arrhythmias (L1-2) P <0.05). 63.33% of those with Q-Td> 79ms or more experienced severe ventricular arrhythmias. Conclusion Q-Td, Q-Tcd value is greater, the higher the incidence of severe ventricular arrhythmias. Q-Td significantly prolonged may predict the occurrence of severe ventricular arrhythmias.