血液透析患者左心室的结构及功能与Q-T离散度的关系

【目的】探讨血液透析患者左心室的结构、功能与QT离散度（QTd）的关系。【方法】对血液透析3个月以上患者30例及30例健康体检者（对照组），分别采用心脏彩超测量其左心室的结构、功能，心电图测量Q-Td、计算校正的QT离散度（Q-Tcd）并比较两组各项指标的差异。【结果】血液透析组的左心室舒末内径（LVEDd），室间隔舒张期厚度（IVST），左室后壁舒张期厚度（PwTH），左室心肌质量指数（LVMI），Q-Td、Q-Tcd均大于对照组；射血分数（EF）及E／A值均小于对照组，且两组相比差异有显著性（P〈0．05）。血液透析组的LVEDd、IVST、PWTH、LVMI与Q-Tcd显著正相关。血液透析组的EF与QTcd显著负相关。两组的E／A与Q-Tcd无显著相关。【结论】血液透析患者Q-Td异常与左心室结构、功能的改变有关，左心室肥厚是导致QT-d异常的一个重要因素，测量QTcd可间接反映血液透析患者的左心室状况。

Relationship of Left Ventricular Structure and Function with QT Dispersion in Patients with Hemodialysis

[Objective] To explore the relationship of left ventricular structure and function with Q-T dispersion（Q-Td） in patients with hemodialysis. [Methods] A total of 30 patients with hemodialysis for more than 3 months and 30 healthy normal subjects（control group） were chosen. Cardiac color Doppler ultrasound was used to measure left ventricular structure and function. Q-Td was measured by echocardiography（ECG）. The corrected Q-Td（Q-Tcd） was calculated. The difference in all parameters between two groups was analyzed. [Results] Left ventricular end diastolic dimension（LVEDd）, interventricular septal thickness（IVST）, left ventricular posterior wall diastolic thickness（PWTH）, left ventricular mass index（LVMI）, Q-Td and Q-Tcd in hemodialysis group were higher than those in control group, while ejection fraction（EF） and E/A value in hemodialysis group were lower than those in control group, and there was significant difference between two groups（ P 〈0.05）. The LVEDd, IVST, PWTH and LVMI in hemodialysis group were positively correlated with Q-Tcd, and negatively correlated with EF value. There was no significant correlation between E/A and Q-Tcd in two groups. [Conclusion] Abnormal Q-Td in patients with hemodialysis is associated with the change of left ventricular structure and function. Left ventricular hypertrophy（LVH） is one of the important factors that cause abnormal QT-d. Measurement of Q-Tcd may indirectly reflect the status of left ventricle.