围产期心肌病QT、JT间期离散度的临床探讨

目的 探讨产期心肌病（ＰＰＣＭ）心电图ＱＴ,ＪＴ间期离散度（ＱＴｄ,ＪＴｄ）与心律失常及死亡的关系。方法 测量并计算３４例ＰＰＣＭ体表心电图ＱＴｄ,ＪＴｄ并将３６例无器质性心脏病的孕产妇作为对照组。结果 ＰＰＣＭ恶性心律失常组ＱＴdisplay status     

急性心肌梗死患者QT、JT离散度与室性心律失常的关系

目的:探讨急性心肌梗死(AMI)患者QT间期离散度(QTd)、JT间期离散度(JTd)与室性心律失常的关系.方法:测量63例AMI患者首次心电图的QTd及JTd,比较有室性心律失常组与无心律失常组的QTd、JTd.结果:AMI有室性心律失常组QTd及JTd显著高于无室性心律失常组,QTd(112.86±33.84)ms对(54.48±24.43)ms,JTd(101.43±36.34)ms对(41.38±19.22)ms,P<0.01.结论:QTd或JTd增大时发生室性心律失常的可能性增大.     

扩张型心肌病QT离散度增加与室性心动过速及心室颤动关系

目的探讨扩张型心肌病患者QT离散度(QTinterval dispersion,QTd)增加与室性心动过速、心室颤动的关系。方法回顾性分析41例扩张型心肌病患者心电图QTd及JT间期离散度(JT interval dispersion,JTd)。结果扩张型心肌病患者QTd和JTd在伴室性心动过速和心室颤动者分别为(101±35)ms或(100±33)ms;而无室性心动过速或心室颤动者分别为(54±18)ms,(57±20)ms,差异有统计学意义(P<0.05,P<0.01)。结论QTd或JTd增加,室性心动过速、心室颤动发生的可能增大,表明QTd或JTd可作为早期预测室性心动过速和心室颤动的一个重要参考指标。     

QT and JT Dispersion in Children with Long QT Syndrome

QT and JT Dispersion in Long QT Syndrome. Introduction: Abnormalities of ventricular repolarization leading to ventricular arrhythmias place children with long QT syndrome at high risk for sudden death. Dispersion of the QT (QTd) and JT (JTd) intervals, as markers of cardiac electrical heterogeneity, may be helpful in evaluating children with long QT syndrome and identifying a subset of patients at high risk for development of critical ventricular arrhythmias (ventricular tachycardia, torsades de pointes, and/or cardiac arrest). Methods and Results: The QTd and JTd intervals in 39 children with long QT syndrome were compared to those of 50 normal age-matched children. In the long QT syndrome group, QTd measured 81 ± 70 msec compared to 28 ± 14 msec in the control group (P < 0.05), and JTd in the long QT syndrome group was 80 ± 69 msec compared to 25 ± 15 msec in the control group (P < 0.05). Conclusion: Children with long QT syndrome have an increased QTd and JTd when compared to normal controls. A QTd or JTd ≥ 55 msec correlates with the presence of critical ventricular arrhythmias. These ECG measures of dispersion can be useful in stratifying children with the long QT syndrome who are at higher risk for developing critical ventricular arrhythmias.     

Differential modulation of electrocardiographic indices of ventricular repolarization dispersion depending on the site of pacing during premature stimulation

INTRODUCTION: Dispersion of ventricular repolarization has been shown to increase with premature stimulation. Moreover, a straight correlation between the amount of dispersion of repolarization and the vulnerability to ventricular fibrillation was reported. On the other hand, differences between right ventricular (RV) and left ventricular (LV) fibrillation threshold have been reported. However, no data exist regarding the influence of the site of stimulation on modulation of dispersion of repolarization. METHODS AND RESULTS: In the present study, several ECG indices of dispersion of repolarization, as a function of the coupling interval and the site of stimulation, were evaluated in a modified Langendorff-perfused rabbit heart (n = 12), with a 5 x 8 array of a simulated body surface unipolar lead system. As the coupling interval was shortened, a biphasic modulation of dispersion of repolarization was found when stimuli were elicited at the LV. In contrast, when the heart was paced from the RV, the dispersion increased monotonically as coupling interval was shortened. CONCLUSION: A differential behavior of the modulation of dispersion of repolarization was found as a function of the site of stimulation.     

J波、JTc、Tp-ec间期对心脏再同步治疗除颤器患者术后触发治疗的预测价值

目的：探讨置入心脏再同步治疗除颤器( CRT-D)患者术前标准12导联心电图中J波、校正JT间期( JTc)、校正Tp-e间期( Tp-ec)对术后触发治疗的预测价值及其相关性。方法选取CRT-D置入患者192例,留取术前标准12导联心电图。读取最长JTc导联中JTc、Tp-ec间期,记录J波阳性病例数。所有患者进行术后随访,程控仪观察识别腔内电图图形并完善体表心电图收集。结果其中接受过触发治疗者(抗心动过速起搏和除颤)44例(触发治疗组),未接受过触发治疗者148例(未触发治疗组),触发治疗组J波阳性率大于未触发治疗组(P<0．05),JTc(P<0．05)、Tp-ec(P<0．001)显著延长。当 JTc≥358．50 ms、Tp-ec≥116．47 ms时,患者术后接受CRT-D触发治疗的风险显著增加,且与术后恶性心律失常的发生有一定相关性,影响患者预后,而J波的预测价值不确定。结论慢性心力衰竭患者术前JTc、Tp-ec的增大增加了CRT-D术后恶性心律失常的发生风险,当JTc≥358．50 ms、Tp-ec≥116．47 ms时,患者发生恶性心律失常的风险显著增加,并可能作为是否接受触发治疗的预测指标。     

CoulterJT血液分析仪特性的探讨

目的　掌握 Coulter JT型血液分析仪的主要特性 ,为临床提供准确、可靠的血液分析数据。方法　用新鲜静脉抗凝血及全血质控品 ,对八项主要参数及白细胞三分类以双盲法进行评价。结果　全血样品红细胞 ( RBC)、血红蛋白 ( HGB)、红细胞比积 ( HCT)、平均红细胞体积 ( MCV)、平均红细胞血红蛋白 ( MCH)和平均红细胞血红蛋白浓度 ( MCHC)的平均批内精密度 ( CV)、总重复性 ( TCV)均 <1 % ,白细胞 ( WBC)平均 CV为 1 .82 % ,TCV为 1 .66% ,血小板 ( PLT)平均 CV为 1 .76% ,TCV为 2 .43%。全血质控品上述 8项参数 1 0天间重复性测定 CV均 <1 %。与 Swelab AC90 0血液分析仪比较 ,对 WBC、RBC、HGB、HCT和PLT五项参数作统计学处理 ,P值均 >0 .0 5 ,相关系数在 0 .9463～ 0 .9970之间。白细胞三分类与手工方法比较 ,中性粒细胞、淋巴细胞和混合类细胞的相关系数 r分别为 0 .95 69、0 .95 62和 0 .6881 ,基本符合仪器设计要求。 WBC、RBC、HGB、HCT和 PLT五项参数污染率均 <1 %。结论　 Coulter JT型血液分析仪性能优良 ,符合设计要求 ,堪称血液分析仪中的精品。     

Taste Exposure Increases Intake and Nutrition Education Increases Willingness to Try an Unfamiliar Vegetable in Preschool Children: A Cluster Randomized Trial

BackgroundIntake of vegetables in children remains low.ObjectiveTo compare taste exposure (TE), nutrition education (NE) and TE+NE together on intake of an unfamiliar vegetable (mooli/daikon radish) in preschool-aged children.DesignChildren attending 11 preschools in England were randomly assigned by clusters to four intervention conditions using a 2×2 factorial design: TE, NE, TE+NE, and no intervention (control).ParticipantsTwo hundred nineteen children aged 2 to 5 years participated from September 2016 to June 2017.InterventionThe intervention period was 10 weeks preceded and followed by measurements of raw mooli intake as a snack. Preschools were randomized to receive weekly TE at snack time (n=62 children); NE (n=68) using the PhunkyFoods program; TE+NE (n=55) received both weekly taste exposures at snack and lessons from the PhunkyFoods program; and the control condition (n=34), received NE after the final follow-up measurement.Main outcome measuresIndividual measured intakes of mooli at Week 1 (baseline), Week 12 (postintervention), and Week 24 and Week 36 (follow-ups).Statistical analysisDifferences in intakes were analyzed by cluster. Logistic regressions were conducted to examine odds ratios for intake patterns.ResultsData from 140 children with complete mooli intake assessments were analyzed. TE increased intake from 4.7±1.4 g to 17.0±2.0 g and this was maintained at both follow-ups. Children assigned to the NE conditions were more likely to eat some of the mooli than children who were not in the NE conditions (odds ratio 6.43, 95% CI 1.5 to 27.8). Combining TE and NE produced no additional benefit to intake beyond TE alone.ConclusionsTaste exposures encouraged children to eat more of the unfamiliar vegetable, whereas nutrition education encouraged children who were noneaters to try the vegetable. Both approaches were effective and can be used to produce different outcomes.     

Gender Differences in Ventricular Repolarization:

NAKAGAWA, M., et al. : Gender Difference in Ventricular Repolarization: Terminal T Wave Interval was Shorter in Woman than in Men . The incidence of sudden death is lower in women than in men, although women have a longer QT interval and are more prone to develop torsades de points than men. It has been recently proposed that the time interval between the apex and end of the T wave (Ta-e) represents the transmural dispersion of ventricular repolarization. Gender and age differences in Ta-e interval have not been fully assessed previously. Standard surface 12-lead ECGs recorded in 760 healthy subjects (382 women, 0–88 years of age) were studied. The intervals from j-point to the apex of the T wave (JaT) and to the end of the T wave (JeT) were measured in lead V₅ in each ECG and corrected by preceding RR intervals using the formula of Bazett (JaTc and JeTc). The Ta-e and Ta-e/JeT ratio were also evaluated. Both JaTc and JeTc intervals were significantly longer in women aged > 20 years than in men of the same age   (P < 0.0001)   . The difference was due to shortening of these intervals after puberty in men. However, the Ta-e interval was significantly shorter in women than in men   (P < 0.05)   and subsequently the Ta-e/JeT ratio was significantly smaller in women than in men (P < 0.0001). The results showed gender differences in the Ta-e interval and JaTc and JeTc intervals in healthy adults, and suggest that the small transmural dispersion of repolarization in women, in spite of the long JaTc and JeTc intervals, might be a beneficial antiarrhythmic property. (PACE 2003; 26[Pt. I]:59–64)