获得性QT间期延长伴尖端扭转型室性心动过速52例临床分析

目的 总结获得性QT间期延长伴尖端扭转型室性心动过速(扭转型室速)患者的危险因素、心电图特征、治疗方法,为临床医生正确识别和处理提供帮助.方法以"扭转型室速"及"QT间期延长"检索阜外心血管病医院1990至2010年病历库,统计获得性扭转型室速患者的临床资料.结果总计52例获得性扭转型室速,其中67.3%有基础心脏病,59.6%存在电解质紊乱,36.5%应用利尿剂,28.8%应用延长QT间期的抗心律失常药.治疗前后平均QTc分别为(571±93)ms及(456±50)ms,所有患者均经补钾、补镁治疗,32.7%应用异丙肾上腺素,13.5%接受临时起搏治疗.结论获得性扭转型室速多发生于电解质紊乱及应用延长QT间期药物的患者.高危患者应监测心电图及QTc变化,注意有预警价值的表现,有助于早期识别并正确治疗.

Abstract：

Objective Risk factors, ECG characteristics and treatment options of patients with Torsade de Points associated with acquired QT prolongation are summarized in this study. Method Using "torsade de points" and "QT prolongation" as the keywords to search the inpatients database from 1990 -2010 of Fuwai hospital, 52 eligible patients were included in this analysis. Results Structural heart diseases were found in 67.3% and electrolyte disorders in 59. 6% patients, 36. 5% patients received diuretic therapy and 28. 8% received antiarrhythmic drugs which might induce prolonged QT interval The mean QTc was (571 ±93)ms and (456 ±50)ms before and after treatment. All patients received potassium and magnesium supplement. Isoproterenol was used in 32. 7% patients. 13.5% patients received temporary pacing therapy. Conclusions Torsade de points and acquired QT interval prolongation was often associated with electrolyte disorders and drugs causing QT prolongation. ECG and QTc should be intensively monitored for high risk patients. Early awareness of the warning signs might contribute to early recognition and proper treatment of patients with Torsade de Points associated with acquired QT prolongation.

Clinical characteristics of 52 patients with torsade de points associated with acquired QT prolongation

Objective Risk factors, ECG characteristics and treatment options of patients with Torsade de Points associated with acquired QT prolongation are summarized in this study. Method Using "torsade de points" and "QT prolongation" as the keywords to search the inpatients database from 1990 -2010 of Fuwai hospital, 52 eligible patients were included in this analysis. Results Structural heart diseases were found in 67.3% and electrolyte disorders in 59. 6% patients, 36. 5% patients received diuretic therapy and 28. 8% received antiarrhythmic drugs which might induce prolonged QT interval The mean QTc was (571 ±93)ms and (456 ±50)ms before and after treatment. All patients received potassium and magnesium supplement. Isoproterenol was used in 32. 7% patients. 13.5% patients received temporary pacing therapy. Conclusions Torsade de points and acquired QT interval prolongation was often associated with electrolyte disorders and drugs causing QT prolongation. ECG and QTc should be intensively monitored for high risk patients. Early awareness of the warning signs might contribute to early recognition and proper treatment of patients with Torsade de Points associated with acquired QT prolongation.