تأثير التحال الدموي على وصلة QT و تشتت وصلة QT عند مرضى القصور الكلوي النهائي
Abstract
شملت هذه الدراسة 30 مريضاً موضوعاً على التحال الدموي المزمن في مشفى الأسد الجامعي باللاذقية، وقد تم استبعاد المرضى المصابين بالداء السكري، نقص التروية القلبية، اضطراب النظم القلبي، أو الذين لديهم ناظم خطا قلبي من هذه الدراسة. تم إجراء تخطيط قلب كهربائي ذي 12 مسرى قبل وبعد التحال الدموي ب10 دقائق، وتم قياس وصلة QT وحساب وصلة QT المصححة(QTc) وتشتت وصلة QT ((QTd في كل حالة، كما تم قياس التراكيز المصلية للشوارد (K ,Ca ,Mg ,P ) إضافة إلى الكرياتينين والبولة الدموية بالتزامن مع إجراء التخطيط .
أظهرت دراستنا تطاولاً واضحاً لوصلة QT لدى المرضى بعد التحال الدموي من 382,93 ± 19,37 ميلي ثانية قبل التحال إلى 405,56 ± 21,59 بعد التحال مع مستوى أهمية P< 0,002 إضافة إلى تطاول تشتت وصلة QT(QTD) من 58,13 ± 6,95 ميلي ثانية قبل التحال إلى 70,2 ± 6,9 ميلي ثانية بعد التحال مع مستوى أهمية P < 0,001، لم يكن هناك أي ترابط بين التغيرات على ال ECG و التغيرات بالمستويات المصلية للشوارد بعد التحال، كما أنها كانت مستقلة عن جنس المريض وعمره و وجود ارتفاع التوتر الشرياني .
Thirty ESRD patients on chronic hemodialysis at Alassad University Hospital, Lattakia, Syria, were included in this study. Patients with diabetes mellitus, ischemic heart disease, cardiac arrhythmias, or pacemaker implantation were excluded from the study.12-leadECG was taken ten minutes before and after hemodialysis. QT interval was measured, QTd,QTc was calculated in each case serum electrolytes (K,Ca,Mg,P) and creatinine and blood urea was measured at the time ECG done. Our study shows an increase of QT interval in patients after hemodialysis from 382.93±19.37ms to 405.56±21.59ms(p<0.002). There is also a significant increase of QTd from 58.13±6.95ms pre dialysis to 70.2±6.9ms post dialysis (p<0.001). There was no correlation between the changes in ECG intervals and the changes in electrolytes after dialysis. It was independent of patient age, gender, and hypertension.
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