蛛网膜下腔出血患者并发长QT间期综合征的危险因素探讨

目的：分析哪些因素与蛛网膜下腔出血患者伴发长QT间期综合征有关。方法：对98例发病2小时内人住我院的蛛网膜下腔出血患者分别记录了年龄、性别以及是否有糖尿病史，测定了每一例的心电图QT间期，用Bazettformula方法计算了经心率校正后的QT间期即QTc，并测定了每一例患者的血钠、血钾、血钙、血镁浓度和血糖水平。用多元线性回归方法分析了蛛网膜下腔出血患者的校正后QT间期即QTc与年龄、性别、血钠、血钾、血钙、血镁浓度及血糖水平的关系。结果：平均QTc间期为469．80±24．19ms。多元线性回归分析表明女性、低血钾及血糖为QTc间期延长的独立危险因素。女性相对于男性的相对危险度为4．23，低血钾(＜3．5mmol/L)者与正常血钾者比较相对危险度为2．86，高血糖(＞7．4mmol/L)患者相对于非高血糖患者(≤7．4mmol/L)的相对危险度为1．10。结论：女性、低血钾浓度及高血糖水平是蛛网膜下腔出血患者QTc延长的独立危险因素。

The study of risk factors of Long QT syndrome(LQT) in the subarachnoid hemorrhage patients

Objective: To analysis the risk factors that affect the occurrence of Long QT syndrome (LQT) in the patients of subarachnoid hemorrhage. Methods: 98 patients of subarachnoid hemorrhage who were admitted in our hospital within 2 hours after onset were studied; We record the age, sex and whether diabetes mellitus of each patient, QT intervals. were measured from the ECG and were corrected for heeart rate using the Bazett formula. And we measured serum levels of sodium, potassium, calcium, magnesium, and glucose. Result: The average corrected QT interval (QTc interval) was 469. 80～24. 19 ms. Patients were categorized into two groups based on the QTc interval, with a cutoff line of 470 ms. Multivariate regression analyses showed that female sex, hypokalemia and high serum glucose level were independent risk factors for severe QTc prolongation. The relative risk associated with female sex was 4. 23 as compared with male sex, hypokalemia (<3. 5 mmol/l) was associated with a relative risk of 2. 86 for QTc prolongation as compared with nonnokalemia, while the relative risk associated with high serum glucose level (>7. 4 mmol/L) was 1. 10 as compared with low serum glucose leve (47. 4 mmol/L). Conclusion: These findings suggest that female sex, hypokalemia and high serum glucose level (>7. 4 mmol/L)are independent risk factors for severe QTc prolongation in patients with SAH.