摘要
目的:观察心肌梗死后抑郁患者QT间期离散度的变化和炎症因子对QT间期离散度的影响。方法:选择2005-01/09在解放军第二五四医院心内科住院的急性心肌梗死患者。患者于2005-11集中来院随访,共随访到35例。根据BECK抑郁自评量表分为抑郁组(≥14分)和非抑郁组(<14分)。行12导同步心电图检查,测量QT间期离散度、校正QT间期;测定血清C反应蛋白、白细胞介素6、Ⅲ型前胶原氨基端肽含量,并分析QT间期离散度、C反应蛋白、白细胞介素6、Ⅲ型前胶原氨基端肽、BECK抑郁自评量表得分的相关关系。结果:35例患者进入结果分析。①心肌梗死后抑郁患者与非抑郁患者相比,QT间期离散度、校正QT间期显著增大[(59.4±17.6)ms,(45.6±13.1)ms;444.0ms,397.5ms,P=0.02,0.03]。②心肌梗死后抑郁患者较非抑郁患者血清C反应蛋白、Ⅲ型前胶原氨基端肽显著增高[(5.50±2.14),(4.08±1.18)mg/L;(88.83±17.62),(76.78±13.47)μg/L,P=0.043,0.049]。③QT间期离散度与C反应蛋白显著正相关(r=0.421,P=0.029),QT间期离散度、C反应蛋白与BECK抑郁自评量表得分之间未见显著相关。结论:①心肌梗死后抑郁患者复极离散程度增大,更易发生心律失常和猝死。②心肌梗死后抑郁患者有更明显的炎症反应和心室重构。③炎症反应可能通过心室重构或其他机制影响复极离散程度。
AIM： To observe the changes of QT dispersion and the effect of inflammatory markers on QT dispersion in depressive patients after myocardial infarction.
METHODS： The patients with acute myocardial infarction （n=35）, who were hospitalized in the Department of Cardiology, the 254 Hospital of Chinese PLA between January and September 2005,/ were intensively followed up in the hospital in November 2005. According to the score of Beck depression inventory （BDI）, the patients were divided into depression group （≥14 points） and without depression group （〈 14 points）. The QT dispersion and corrected QT interval duration were measured with 12-lead simultaneous eleetrocardiographic examination; The contents of C reaction protein, interleukin-6 and N-terminal peptide of type Ⅲ procollagen （P Ⅲ NP） in serum were detected, and the correlations among QT dispersion, C reaction protein, interleukin-6, PⅢNP and the score of BDI were analyzed.
RESULTS： All the 35 patients were involved in the analysis of results. ① The QT dispersion and corrected QT interval duration in the depressive patients after myocardial infarction were significantly increased as compared with those without depression [（59.4±17.6） ms,（45.6±13.1） ms; 444.0 ms, 397.5 ms; P=0.02, 0.03]. ② The contents of C reaction protein and P Ⅲ NP were significantly higher in the depressive patients after myocardial infarction than in those without depression [（5.50±2.14）, （4.08 ±1.18） mg/L; （88.83±17.62）, （76.78±13.47） μg/L, P=0.043, 0.049]. ③ The QT dispersion was positively correlated with the C reaction protein （r=0.421, P=0.029）, but the QT dispersion and C reaction protein had no significant correlation with the score of BDI.
CONCLUSION： ① The QT dispersion is greatly increased in the depressive patients after myocardial infarction, which indicates that depressive patients are at higher risk of arrhythmias and sudden death. ② The depressive patients after myocardial infarction have more obvious inflammatory reaction and cardiac ventricular remodeling. ③Inflammatory reaction may contribute to the prolonged QT dispersion through cardiac ventricular remodeling or other mechanisms.
出处
《中国临床康复》
CAS
CSCD
北大核心
2006年第18期26-28,共3页
Chinese Journal of Clinical Rehabilitation
