严重脓毒症患者中QTd动态变化对患者预后评估作用

Effect of QTd Change on the Prognosis of Patients with Severe Sepsis

摘要: 目的：评价QTd (QT dispersion)变化与严重脓毒症患者治疗预后评估的价值。方法：前瞻性观察57例严重脓毒症患者，分成存活组和死亡组。存活组治疗前、治疗后第一天、治疗后第三天和第七天患者抽血查PCT、BNP和做心电图(ECG)，死亡组治疗前、治疗后第一天和第三天患者抽血查PCT、BNP和ECG。结果：PCT在存活组随着时间延长而降低，而死亡组则相反。BNP无论是存活组和死亡组在第一天中都增高，而存活组中随着时间延长，BNP则下降，死亡组则相反。QTd无论存活组和死亡组在第一天QTd均增高，而在存活组中则在第三天和第七天逐渐下降，死亡组中增高后再也没有下降。结论：QTd动态变化可作为脓毒症心脏损害一个指标，但需要进行性观察。

Abstract: Purpose: To evaluate the value of changes in QTd (QT dispersion) and prognosis in patients with severe sepsis. Methods: 57 patients with severe sepsis were prospectively observed and divided into survival group and death group. PCT, BNP and ECG were examined before treatment, on the first day after treatment, on the third and seventh day after treatment in survival group, and PCT, BNP and ECG were examined before treatment, on the first and third day after treatment in death group. Result: PCT decreased with time in survival group, but decreased in death group. BNP in-creased in both survival and death groups on the first day, but decreased with time in survival group, whereas decreased in death group. QTd increased on the first day in both survival group and death group, but decreased gradually on the third and seventh day in survival group, and did not decrease after increasing in death group. Conclusion: The dynamic changes of QTd can be used as an index of cardiac damage in sepsis. But continuous observation is needed.