手足口病患儿校正QT间期离散度的水平变化及临床意义

目的探讨手足口病(HFMD)患儿校正QT间期离散度(QTcd)测定的临床意义及其与心肌肌钙蛋白T(cTnT)的相关性。方法选择HFMD患儿100例为研究组,随机匹配98例健康儿童为对照组。所有入选对象均描记12导联同步体表心电图,用心率校正得QTcd,同时行cTnT定量检测。cTnT阳性组按预后分为病情好转组与病情加重组,均于治疗第7 d复查心电图、cTnT。结果治疗前cTnT阳性组QTcd、cTnT大于阴性组、对照组(P均0.05),阴性组大于对照组(P0.05);治疗前病情加重组QTcd、cTnT大于病情好转组(P0.05),病情好转组治疗后QTcd、cTnT较治疗前降低(P0.05),而病情加重组治疗后则上升(P0.05);QTcd与cTnT值呈正相关(r=0.802,P=0.000)。结论早期动态监测QTcd的变化有助于HFMD患儿心肌损害的早期诊断和治疗。

Changes and clinical value of corrected QT interval dispersion in children with hand-foot-mouth disease

Objective To study the clinical significance of measuring corrected QT interval dispersion （QTcd） in children with hand - foot - mouth disease （HFMD） and its correlation with cardiac troponin T （cTnt）. Methods Data about 12 - lead si- multaneous body surface electrocardiogram （12ECY.;-） were recorded and the levels of cTnT were detected in 100 HFMD children and 98 healthy children （control group）. The values of QTcd and cTnT were calculated in the 7th day after treatment in cTnT positive group which was divided into the improved group and the worsened group according to the prognosis. Results Before the treatment, the QTed and cTnT in the positive group were higher than those in the negative group and the control group （both P 〈 0.05 ） ; moreover, the QTed and cTnT were higher in the negative group than in the control group （P 〈 0.05 ）. Be- fore the treatment, the QTcd and cTnT in the worsened group were higher than those in the improved group （P〈0. 05）. After the treatment, the QTcd and cTnT decreased in the improved group （P 〈 0.05）, but increased in the worsened group （P 〈 0.05）. QTcd was positively corrdated with cTnT levd （ r = 0. 802, P = 0. 000）. Conclusions Early dynamic monitoring of the changes of QTcd is conducive to diagnosing and treating myocardial iniurv in children with HFMD.