完全性房室传导阻滞患者发生尖端扭转型室性心动过速的危险因素分析

目的　分析完全性房室传导阻滞患者发生尖端扭转型室性心动过速 (Td P)的危险因素。方法　用 logistic回归法分析 116例完全性房室传导阻滞住院患者 Td P的发生率与年龄、性别、治疗前血钾浓度、QT间期、校正的 QT间期 (QTc)、心率 (HR)的相关性。结果　 12例患者 (10 .3% )发生 Td P,其中女性 9例。Td P组血钾浓度为 (3.5 4±0 .5 5 ) m mol/ L ,明显低于未发生 Td P组血钾浓度 (4 .0 1± 0 .5 7) mm ol/ L (P<0 .0 1)。 Td P组 QT间期为 (0 .5 7±0 .0 75 ) s,明显大于未发生 Td P组 QT间期 (0 .4 6 5± 0 .0 93) s,(P<0 .0 1)。 Td P组年龄、HR、QTc与未发生 Td P组无显著差异。女性、血钾浓度和 QT的风险比值 (OR)分别为 5 .6 39、6 .773和 5 .90 5 ;而年龄、HR、QTc的 OR分别为 1.0 12、0 .92 5、1.0 30。结论　完全性房室传导阻滞患者发生 Td P的独立危险因素是低血钾浓度、长 QT间期和女性。对女性完全性房室传导阻滞患者应给予更积极的治疗 ,以免发生 Td P。

Risk factors of torsade de pointes in patients with complete atrial ventricular block

Objective To analysze the risk factors of torsade de pointes(TdP) in patients with complete atrial ventricular block. Methods 116 patients with complete atrial ventricular block were included. The relationship between TdP and age, sex, potassium concentration of blood before treatment, QT interval, corrected QT interval(QTc), heart rate(HR) was analyzed by multivariate logistic regression analysis. Results 12 patients developed TdP, including 9 women. The potassium concentration of patients with TdP was lower than patients without TdP( 3.54±0.55mmol/L vs 4.01±0.57mmol/L, P<0.01). QT interval of patients with TdP was longer than patients without TdP(0.57±0.075s vs 0.465±0.093 s, P<0.01). Age, HR, QTc were not different between two groups. Odds ratio(OR) were 5.639(female), 6.773(potassium concentration), 5.905(QT interval), 1.012(age), 0.925(HR), 1.030(QTc). Conclusion Risk factors of TdP in patients with complete atrial ventricular block were female,lower potassium concentration and longer QT interval. Female patient with complete atrial ventricular block should be treated more positively to prevent TdP.