CAJ | 학술논문

目的探讨慢性盐负荷及补钾对健康成人QT间期离散度(QTd)、T波峰-末间期(Tp-Te)的影响.方法选取64例28～60岁血压正常者参与为期3周的慢性盐负荷及补钾试验,包括基线调查3 d(基线期),低盐饮食(低盐期)、高盐饮食(盐负荷期)和高盐补钾饮食(高盐补钾期)各7d.各期均测量体质量、血压,记录心电图,测量QT间期、QTd、校正QTd (QTdc)及Tp-Te.结果低盐期QTd、QTdc、Tp-Te均＜基线期(QTd,45.6± 15.6对52.1 ±23.4,P＜0.05；QTdc,55.6±19.4对61.6±23.6,P＜0.05；Tp-Te,79.8±8.5对85.0±10.6,P＜0.01)；盐负荷后QTdc、Tp-Te＞低盐期(QTdc,60.3±19.4对55.6±19.4,P＜0.05；Tp-Te,83.0±10.1对79.8±8.5,P＜0.01)；在高盐摄入的基础上大剂量口服补钾QTd、QT-dc、Tp-Te均较高盐期缩小(QTd,42.6±15.1对47.4±19.0,P＜0.05；QTdc,52.2±18.0对60.3±19.4,P＜0.05；Tp-Te,79.1 ±8.5对83.0±10.1,P＜0.01).结论盐负荷可升高血压并使QTd、QTde及Tp-Te增加,补钾可以减低高盐对QTd、QTdc、Tp-Te的影响,提示补钾可通过缩短心肌复极时间,降低心脏复极不均一性,对心律失常可能有一定预防作用.
목적 탐토만성염부하급보갑대건강성인QT간기리산도(QTd)、T파봉-말간기(Tp-Te)적영향.방법 선취64례28～60세혈압정상자삼여위기3주적만성염부하급보갑시험,포괄기선조사3 d(기선기),저염음식(저염기)、고염음식(염부하기)화고염보갑음식(고염보갑기)각7d.각기균측량체질량、혈압,기록심전도,측량QT간기、QTd、교정QTd (QTdc)급Tp-Te.결과 저염기QTd、QTdc、Tp-Te균＜기선기(QTd,45.6± 15.6대52.1 ±23.4,P＜0.05；QTdc,55.6±19.4대61.6±23.6,P＜0.05；Tp-Te,79.8±8.5대85.0±10.6,P＜0.01)；염부하후QTdc、Tp-Te＞저염기(QTdc,60.3±19.4대55.6±19.4,P＜0.05；Tp-Te,83.0±10.1대79.8±8.5,P＜0.01)；재고염섭입적기출상대제량구복보갑QTd、QT-dc、Tp-Te균교고염기축소(QTd,42.6±15.1대47.4±19.0,P＜0.05；QTdc,52.2±18.0대60.3±19.4,P＜0.05；Tp-Te,79.1 ±8.5대83.0±10.1,P＜0.01).결론 염부하가승고혈압병사QTd、QTde급Tp-Te증가,보갑가이감저고염대QTd、QTdc、Tp-Te적영향,제시보갑가통과축단심기복겁시간,강저심장복겁불균일성,대심률실상가능유일정예방작용.
Objective To investigate the effects of dietary sodium intake on QT interval dispersion (QTd) in normotensive healthy adults and the protective effect of dietary potassium.Methods Sixty-four normotensive subjects,aged 28 to 60,were enrolled and sequentially maintained on a protocol with 3 days baseline investigation,7 days low salt diet ( 3 g/d,NaCl),7 days high salt diet ( 18 g/d),and high salt diet with potassium supplementation (4.5 g/d,KCl) for another 7 days.On the second day and the last three days of each period,blood pressure were measured by physicians who were trained and standardized and electrocardiogram was recorded in the end of each period.QT interval、QTd and Tpeak-Tend interval (Tp-Te) were measured and calculated.Results After salt loading,corrected QT interval (QTc) 、corrected QT interval dispersion (QTdc)and Tp-Te were prolonged (QTdc,60.3± 19.4 vs 55.6 ± 19.4,P＜0.05 ;Tp-Te,83.0± 10.1 vs.79.8 ± 8.5,P＜0.01).Surprisingly,all the changes were reversed by potassium supplementation ( QTd,42.6±15.1 vs 47.4±19.0,P＜0.05 ;QTdc,52.2± 18.0 vs 60.3± 19.4,P＜0.05 ; Tp-Te,79.1 ± 8.5 vs 83.0± 10.1,P＜0.01 ).Conelusions Salt loading induced high blood pressure and prolonged QT interval、QTd and Tp-Te in healthy adults,while dietary potassium supplementation could reverse these alterations.It suggests that potassium supplementation may not only lower the blood pressure,but also improves heterogeneities of repatriation time and maybe prevent arrhythmias.