Sirozlu hastalarda Q-T araligindaki degisiklikler
Q-T interval prolongation in cirrhotic patients
Pamukkale Üniversitesi Tip Fakültesi Iç hastaliklari Bilim Dali2, Gastroenteroloji Bilim Dali3 ve Biyokimya Bilim Dali4, Denizli
Özet
Giris ve amaç: Karaciger sirozlu olgularda aritmiler, ani kardiyak ölümler sik görülmektedir. Uzamis Q-T araligi karaciger sirozlu olgularda kardiyak ritim problemlerinden sorumlu olabilir. Biz bu çalismada karaciger sirozlu olgularda Q-T mesafesini, bunun karaciger hastaliginin nedeni ve siddeti ile iliskisini arastirmayi amaçladik. Gereç ve yöntem: Çalismaya bilinen kalp hastaligi olmayan 65 karaciger sirozlu olgu (yas 40-72) ve kontrol grubu olarak 45 saglikli olgu (yas 45-60) alindi. Olgularin karaciger fonksiyon testleri, serum elektrolit, üre, kreatinin ölçümleri yapildi. Karaciger sirozunun derecesi Child-Pugh kriterlerine göre belirlendi. Tüm olgularin EKG kayitlarindan Bazet formulüne göre düzeltilmis Q-T (Q-Tc) mesafesi hesaplandi. Bulgular: Sirozlu olgularda Q-T araligi kontrol grubundan anlamli oranda daha uzun saptandi (437± 2,9 ms ve 365±2,8 ms p<001). Q-T mesafesi hastaligin siddeti (r:0.53, p<0.05), ve prothrombin zamani ile (r:0.60, p<0.001) pozitif iliski gösterirken serum albumin düzeyi ile negatif iliski saptandi (r:- 0.40, p<0.001) Alkolik ve viral hepatite bagli siroz olgulari arasinda QT mesafesi arasinda anlamli fark mevcut degildi. Sonuç: Sirozlu olgularda Q-T araligi ölçümleri hastalarin takibinde kullanilabilecek ve prognoz kriterlerine dahil edilebilecek önemli bir gösterge olabilir.
Abstract
Background and aims: A prolonged Q-T interval is a risk factor for cardiac arrhythmias and sudden cardiac arrest. In this study, Q-T interval changes in cirrhotic patients at different stages and with different etiologic factors was evaluated. Possible causes of Q-T wave abnormality in cirrhotic patients were also evaluated. Materials and methods: Sixty five cirrhotic patients (40-72 years old) and 45 healthy volunteer subjects (45-60 years old) were included in the study. Liver function tests in addition to complete blood count, serum electrolytes, creatinine, prothrombin time and thyroid functions were also measured. Ascites was evaluated by ultrasound examination, encephalopathy history was recorded for each patient and stages of cirrhotic patients were graded according to Child- Pugh’s criteria. The Q-T interval was calculated according to the Bazet formula. Results: The Q-T interval was longer in cirrhotic patients (437±2.9 ms versus 365±2.8 ms p<001). It was positively correlated with prothrombin time and negatively associated with serum albumin level. The etiology of cirrhosis did not seem to effect the Q-T interval. Conclusion: These results indicate that the Q-T interval is closely associated with severity of liver disease independent from the etiology of the disease. Assessment of the Q-T interval is simple test that could be used in the follow-up of cirrhotic patients
