皮肤黏膜淋巴结综合征患儿QT间期离散度和P波离散度变化

目的　探讨用预测可能发生心律失常的心电学指标QT间期离散度 (QTd)和P波离散度 (Pd)来研究皮肤黏膜淋巴结综合征 (MCLS)患儿发生心律失常的可能性。方法　MCLS患儿 6 2例 (13例伴有冠脉扩张 ) ,随机匹配 79例健康儿童为对照。采用广东中山SR - 10 0 0A心电综合自动分析仪描记 12导联同步体表心电图 (12ECG) ,选择波形清晰的 3个心动周期 ,在人工干预下自动测量窦性节律时心率 (HR)、QTmax、QTmin、Pmax、Pmin ,计算QTd及Pd ,连测 3次后取其平均值。结果　与对照组比较 ,MCLS组急性期心率增快 (P <0 0 1) ,QTmax、QTmin缩短 ,QTd增大 ,Pmax增加 ,Pmin缩短 ,Pd增大 ;恢复期QTd、Pmax、Pd延长 ,其差异均有显著性 (P <0 0 1或P <0 0 5 )。伴有冠脉扩张与不伴有冠脉扩张的MCLS患儿之间QTmax、QTmin、QTd、Pmax、Pmin、Pd差异无显著性 (P >0 0 5 )。结论　MCLS能引起QTd及Pd增加 ,有可能发生严重心律失常 ,临床上不容忽视

Changes of QT interval dispersion and P wave dispersion in children with mucocutaneous lymph node syndrome

Objective To study the changes of QT interval dispersion (QTd) and P wave dispersion (Pd), two non-invasive markers of susceptibility to arrhythmia, so as to predict the possibility of developing arrhythmia in children with mucocutaneous lymph node syndrome (MCLS). Methods 12-lead simultaneous body surface electrocardiogram (12ECG) data were recorded with SR-1000 A automated electrocardiograph made by Guangdong Zhongshan in 62 patients with MCLS (13 children with coronary artery distension) and in 79 healthy children (control group). The values of heart rate (HR), QTmax, QTmin, Pmax and Pmin were tested and the values of Pd (Pmax-Pmin) and QTd (QTmax-QTmin) were calculated. Results Compared with the 12ECG records of the control group, HR increased, QTmax and QTmin shorten while QTd prolonged ( P <0.01 or P <0.05); Pmax prolonged and Pmin shorten, so Pd prolonged ( P <0.01) in children with MCLS in acute phase. QTd, Pmax and Pd remained prolong untill the recovery phase ( P <0.01). The changes of QTmax, QTmin, QTd, Pmax, Pmin and Pd were not related to coronary artery distension. Conclusion MCLS can induce increase of QTd and Pd and develop arrhythmia in pediatrics.[