Abstract：【Objective】To explore the predictive value of electrocardiogram Q-T dispersion (QTd) for cardiovascular events in maintenance hemodialysis (MHD) patients. 【Methods】A total of 182 patients with MHD who were treated in our hospital were selected as the research objects. During the 1-year follow-up, the cardiovascular events of MHD patients were counted and divided into the occurrence group and the non-occurring group according to whether a cardiovascular event occurred. Clinical data of patients in the occurrence group and the non-occurrence group were compared. Logistic multivariate regression was analyzed for related factors affecting cardiovascular events in MHD patients. The receiver operating characteristic curve (ROC) was drawn to analyze the predictive power of electrocardiogram QTd for cardiovascular events in MHD patients. 【Results】The incidence of cardiovascular events in this study was 23.63%(43/184). The dialysis age, blood creatinine, blood phosphorus, cystatin C and QTd of the occurrence group were significantly higher than those of the non-occurring group (P<0.05), and the residual kidney filtration rate of the occurrence group was significantly lower than that of the non-occurring group (P<0.05). Logistic regression analysis showed that residual kidney filtration rate, cystatin C and QTd were the influencing factors of cardiovascular events in MHD patients (OR=3.133, 2.776, 3.554, respectively, P<0.05). ROC analysis showed that the best cut-off points of ECG QTd for predicting cardiovascular events in MHD patients were 62.78 ms, and the sensitivity, specificity and area under the curve (AUC) were 62.79%, 75.54%, and 0.744, respectively. 【Conclusion】Electrocardiogram QTd has a high predictive power for cardiovascular events in MHD patients, and can be used as an important reference index for predicting cardiovascular events in MHD patients.
邵姗姗, 万甜甜, 罗爱红. 心电图Q-T离散度对维持性血液透析患者发生心血管事件的预测价值[J]. 医学临床研究, 2022, 39(2): 201-204.
SHAO Shan-shan, WAN Tian-tian, LUO Ai-hong. Predictive Value of Q-T Dispersion of Electrocardiogram for Occurrence of Cardiovascular Events in Patients with Maintenance Hemodialysis. JOURNAL OF CLINICAL RESEARCH, 2022, 39(2): 201-204.
[1] VIECELLI A K, O'LONE E, SAUTENET B, et al. Vascular Access outcomes reported in maintenance hemodialysis trials: a systematic review[J].Am J Kidney Dis,2018, 71(3):382-391. [2] SAGLIMBENE V M, WONG G, RUOSPO M, et al. Fruit and vegetable intake and mortality in adults undergoing maintenance hemodialysis [J].Clin J Am Soc Nephrol,2019, 14(2):250-260. [3] ERRE G L, PIAS A, PIGA M, et al. QT and QT dispersion intervals in long-standing and moderately active rheumatoid arthritis: results from a multicentre cross-sectional study [J].Clin Exp Rheumatol,2020, 38(3):516-522. [4] BRASCHI A, FRASHERII A, LOMBARDO R M, et al. Association between tpeak-tend/qt and major adverse cardiovascular events in patients with takotsubo syndrome [J].Acta Cardiol,2020, 12(5):1-7. [5] 巴元明, 王小琴. 慢性肾衰竭[M]. 北京:中国医药科技出版社, 2010: 218-230. [6] ERDOGAN E, AKKAYA M, BACAKSIZ A, et al. Short-term effect of percutaneous recanalization of chronic total occlusions on QT dispersion and heart rate variability parameters [J].Med Sci Monit,2013, 19:696-702. [7] 姚成增. 心血管内科常见病诊疗手册[J].中国临床医生杂志, 2018, 46(12):3-7. [8] TANAKA Y, OHYA M, YANO T, et al. Association between serum lipids, polyunsaturated fatty acids, and prognosis in maintenance hemodialysis patients [J].Hemodial Int,2020, 27(12):258-263. [9] BORZYCH-DUZALLKA D, SHROFF R, ARICETA G, et al. Vascular access choice, complications, and outcomes in children on maintenance hemodialysis: findings from the international pediatric hemodialysis network (iphn) registry [J].Am J Kidney Dis,2019, 74(2):193-202. [10] XU Q, LI H, ZHANG X, et al. Tanshinone IIA elevates serum soluble klotho levels and decreases cardiovascular events in patients on maintenance hemodialysis: a prospective before-after study[J].Ann Palliat Med,2020, 9(4):2131-2140. [11] 张琨, 王少亭, 胡晓舟, 等. 维持性血液透析患者并发心血管疾病危险因素分析[J].山东医药, 2017, 57(4):82-84. [12] WU J C, GANG P, YOSHIDA Y, et al. Towards precision medicine with human ipscs for cardiac channelopathies [J].Circ Res,2019, 25(6):653-658. [13] CAMPLEMAN S L, BRENT J, PIZON A F, et al. Drug-specific risk of severe QT prolongation following acute drug overdose [J].Clin Toxicol,2020, 58(12):1326-1334. [14] 李友河, 彭翔, 薛志强, 等. 维持性血液透析患者心电图QT间期离散度与心血管事件的相关性[J].海南医学, 2018, 29(7):23-25. [15] HOUGHTON R, de VRRIES F, LOSS G. Psychostimulants/atomoxetine and serious cardiovascular events in children with ADHD or autism spectrum disorder [J].CNS Drugs,2020, 34(1):93-101.
2022, Vol. 39 
