CAJ | 학술논문

目的通过对QT间期延长伴尖端扭转型室性心动过速(扭转型室速)患者治疗的随访,总结QT间期延长综合征(LQTs)的诊疗经验,评价其预后.方法患者32例,分析其诱发因素、临床表现、心电图特点、随访治疗效果.结果 15例为遗传性,17例为获得性.女性多于男性.部分遗传性患者发病时有诱发因素,获得性患者均有明确诱因.15例遗传性患者均接受β受体阻滞剂及补钾、补镁治疗,5例置入埋藏式心律转复除颤器(ICD),2例置入双腔起搏器;平均随访时间为(39.4±25.1)个月,随访期间4例患者发生扭转型室速、晕厥.17例获得性患者中,8例置入起搏器,1例置入ICD;平均随访时间为(30.9±13.3)个月,随访期间1例扩张型心肌病患者猝死;ICD置入者因扭转型室速发作而行放电1次.结论就诊的患者中,获得性LQTs多于遗传性LQTs,遗传性LQTs患者较获得性预后差,获得性患者中只有对伴有心脏结构改变的患者才考虑选择置入ICD或心脏再同步化复律除颤器治疗.
목적 통과대QT간기연장반첨단뉴전형실성심동과속(뉴전형실속)환자치료적수방,총결QT간기연장종합정(LQTs)적진료경험,평개기예후.방법환자32례,분석기유발인소、림상표현、심전도특점、수방치료효과.결과 15례위유전성,17례위획득성.녀성다우남성.부분유전성환자발병시유유발인소,획득성환자균유명학유인.15례유전성환자균접수β수체조체제급보갑、보미치료,5례치입매장식심률전복제전기(ICD),2례치입쌍강기박기;평균수방시간위(39.4±25.1)개월,수방기간4례환자발생뉴전형실속、훈궐.17례획득성환자중,8례치입기박기,1례치입ICD;평균수방시간위(30.9±13.3)개월,수방기간1례확장형심기병환자졸사;ICD치입자인뉴전형실속발작이행방전1차.결론취진적환자중,획득성LQTs다우유전성LQTs,유전성LQTs환자교획득성예후차,획득성환자중지유대반유심장결구개변적환자재고필선택치입ICD혹심장재동보화복률제전기치료.
Objective To summarize the clinical characteristics and outcome of patients with long-QT syndrome (LQTs) accompanied with torsade de pointes. Methods Thirty-two eligible patients were included in this study. Clinical and electrocardiographic data were analyzed and telephone or out-patient follow-up were made in all patients. Results There were 15 patients with inherited LQTs (h-LQTs) and 17patients with acquired LQTs (a-LQTs). There are more women (n =24) than men (n =8). β blockers,potassium and magnesium supplement were the basic therapy for h-LQTs patients, bivent pacemaker was implanted in 2 patients and implantable cardioverter defibrillator was implanted in 5 patients. Ventricular tachyarrhythmias and syncope occurred in 4 patients during (39.4 ± 25. 1 ) months follow-up. In 17 a-LQTs patients, one patient with dilated cardiomyopathy died suddenly and another patient with implanted cardioverter defibrillator experienced one ventricular tachycardia during (30. 9 ± 13. 3 ) months followup. Conclusions The prognosis in h-LQTs and a-LQTs patients with structure heart disease is poor. ICD or CRT-D therapy is suggestive for a-LQTs patients with structure heart disease.