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目的探讨肝硬化患者心电图 Q-T 间期(Q-Tc)延长与肝硬化的严重程度及预后的相互关系。方法对126例肝硬化患者及126例健康对照的心电图 Q-Tc 进行比较;肝硬化患者按Child-Pugh 分级后,观察各级间心电图 Q-Tc、凝血酶原时间(PT)、血清白蛋白(ALB)、血清总胆红素(TBIL)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、γ谷氨酰转移酶(GGT)、碱性磷酸酶(ALP)、血清钾、血清钙等指标;观察20例肝硬化晚期行肝移植手术患者手术前后的心电图 Q-Tc 及上述生化指标。结果肝硬化患者的 Q-Tc 较健康对照明显延长(P<0.01);肝硬化患者各级间 Q-Tc 随 Child分级呈现逐渐增高趋势,A 级与 B、C 级 Q-Tc 差异有统计学意义(均 P<0.01),B、C 级之间差异无统计学意义;直线相关分析 Q-Tc 与 Child 积分呈正相关(r=0.56,P<0.05);20例术前 Q-T 延长的肝移植患者术后17例患者 Q-Tc 恢复正常,3例患者明显较术前缩短。结论肝硬化患者存在 Q-Tc 延长,且随着病情的严重程度增加,Q-Tc 异常率增高。肝移植后往往恢复正常。Q-Tc 延长在判定肝硬化患者病情程度及预后上有重要的临床意义。
Objective To investigate the relationship between the Q-T interval (Q-Tc) and the severity and prognosis of cirrhosis in cirrhotic patients. Methods The electrocardiogram Q-Tc was compared between 126 cirrhotic patients and 126 healthy controls. The levels of Q-Tc, PT, serum albumin ALB, TBIL, ALT, AST, GGT, ALP, serum potassium , Serum calcium and other indicators; observed 20 cases of liver cirrhosis patients undergoing liver transplantation before and after surgery ECG Q-Tc and the above biochemical indicators. Results The Q-Tc in patients with cirrhosis was significantly longer than that in healthy controls (P <0.01). The Q-Tc in patients with cirrhosis was gradually increased with Child’s grading. There was a statistically significant difference in Q-Tc between A and B, C (P <0.01). There was no significant difference between B and C levels. There was a positive correlation between Q-Tc and Child’s score (r = 0.56, P <0.05) Q-Tc in 17 patients returned to normal after operation, and 3 patients were significantly shorter than those before operation. Conclusion There is a prolongation of Q-Tc in patients with cirrhosis. As the severity of the disease increases, the abnormal rate of Q-Tc increases. Often returned to normal after liver transplantation. Q-Tc prolongation in the determination of the severity of patients with cirrhosis and prognosis have important clinical significance.