论文部分内容阅读
目的:探讨先天性长QT综合征(LQTS)患者β受体阻滞剂治疗效果的预测因子。方法:给予26例LQTS患者口服心得安(16例)和美托洛尔(10例)治疗38个月。评定治疗前后临床症状、心率、校正QT间期(QTc)以及左室射血分数的变化。结果:22例接受β受体阻滞剂治疗患者的心脏事件减少50%以上。在治疗有效的患者中,人均晕厥次数从(16.2±5.1)减少到(1.1±0.9)(P<0·01),人年均晕厥次数从(4.5±1.2)减少到(0.7±0.6)(P<0·01),QTc从(0.56±0.06)s减少到(0.50±0.03)s(P<0·01)。在心得安与美托洛尔治疗的患者中晕厥次数和QTc的减少差异无统计学意义。多元回归分析显示晕厥发作减少与患者的年龄、性别、心率或左心室功能无关(P>0·05)。QTc减少是晕厥控制的惟一独立预测因子(r=0.81,P<0·01)。结论:口服β受体阻滞剂是LQTS患者有效的治疗方法,QTc显著减少高度预示β受体阻滞剂治疗成功。
Objective: To investigate the predictive value of β-blocker therapy in patients with congenital long QT syndrome (LQTS). Methods: Twenty-six patients with LQTS were given propranolol (16 cases) and metoprolol (10 cases) for 38 months. The clinical symptoms, heart rate, corrected QT interval (QTc) and left ventricular ejection fraction before and after treatment were assessed. Results: Cardiac events were reduced by more than 50% in 22 patients treated with beta-blocker. The number of syncope per capita decreased from (16.2 ± 5.1) to (1.1 ± 0.9) (P <0.01), and the average number of people with syncope decreased from (4.5 ± 1.2) to (0.7 ± 0.6) P <0.01), QTc decreased from (0.56 ± 0.06) s to (0.50 ± 0.03) s (P <0.01). There was no significant difference in the number of syncope and QTc in patients treated with propofol and metoprolol. Multivariate regression analysis showed that the reduction of syncope was independent of the patient’s age, sex, heart rate or left ventricular function (P> 0.05). QTc reduction was the only independent predictor of syncope control (r = 0.81, P <0.01). Conclusion: Oral β-blockers are an effective treatment for patients with LQTS. QTc markedly reduce the highly predictive success of β-blocker therapy.