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目的从循证医学角度探讨QT离散度(QTd)在慢性肾功能衰竭患者(ESRD)血液透析(HD)前后的变化。方法应用meta分析的方法比较血液透析前组与透析后组QTd值,采用Revman4.2.10统计学软件,以加权平均数(WMD)为效应量进行合并分析。结果 8个研究的合并效应量(WMD)为-12.53,95%可信区间为(-24.63,-0.43),合并效应检验z=2.03,P<0.05。结论 HD可使QTd增大,透析后应注意防范恶性心律失常的出现,防止心源性猝死的发生。
Objective To explore the changes of QTd in patients with chronic renal failure (ESRD) before and after hemodialysis (HD) from the perspective of evidence-based medicine. Methods Meta-analysis was used to compare the QTd values of pre-hemodialysis group and post-dialysis group. The data were analyzed by Revman 4.2.10 statistical software and weighted average (WMD) as the effect amount. Results The combined effect (WMD) of the 8 studies was -12.53, with 95% confidence interval (-24.63, -0.43). The combined effect test z = 2.03, P <0.05. Conclusions HD can increase QTd. After dialysis, care should be taken to prevent the occurrence of malignant arrhythmia and prevent sudden cardiac death.