原发性高血压的QT离散度分析

目的：研究原发性高血压左室重量（ＬＶＭ）对ＱＴ间期离散度（ＱＴｄ）的影响及ＱＴｄ对室性心律失常的预测作用。方法：检测１５０例患者的ＱＴ、ＪＴ、ＱＴｃ、ＪＴｃ离散度和超声心动图，其中６８例行２４小时动态心电图监测。结果：原发性高血压的复极离散度大小与左室重量呈正相关，伴左室肥厚者（ＬＶＨ组）的ＱＴｄ大于无左室肥厚者（对照组）（Ｐ＜０．０１），有持续性室速发生者（ＳＶＴ组）的复极离散度大于无室性心律失常者（对照组）（Ｐ＜０．０１），仅有室性期前收缩者（ＶＰＣ组）的ＱＴｄ与对照组无明显差异（Ｐ＞０．０５）。结论：复极离散度的大小主要与左室重量有关，伴左室肥厚者的心性猝死率增加可能与ＱＴｄ的增大有关，ＱＴｄ的变化可作为原发性高血压恶性室性心律失常的预测指标。

ANALYSIS OF QT DISPERSION IN PRIMARY HYPERTENSION

Objective:Studying the influence of left ventricular mass (LVM)in primary hypertension toward QT interval dispersion (QTd) and the value of QTd in the prediction of ventricular arrhythmias.Methods:150 patients were determined for their QT,JT,QTc,JTc dispersion and ecchocardiograms,among them 68 patients were observed with 24 hours,EKG determination.Results:In primary hypertension the size of repolarized dispersion was positively related with left ventricular mass;with left ventricular hypertrophy (LVH group) the QTd was greater than that of no left ventricular hypertrophy (control group) (P<0.01);with sustained ventricular tacchycardia (SVT group) the repolarized dispersion was greater than that of no ventricular arrhythmias (P<0.01).Conclusions:The size of repolarized dispersion is mainly related with left ventricular mass.The increase of the rate of cardiac sudden death is probably related with enlargement of QTd.Thus,the change of QTd can be used as a parameter in malignant ventricular arrhythmias with primary hypertension.