长QT间期综合征患者的脑电分析

发布时间：2018-04-15 00:09

本文选题：脑电图 + 长QT间期综合征　；参考：《安徽医科大学》2017年硕士论文

【摘要】：目的长QT间期综合征(LQTS)又称复极延迟综合征,是指心电图上QT间期延长,并且伴有T波与(或者)U波的形态异常,临床上主要表现为室性心律失常、晕厥、猝死以及癫痫发作的一组综合征。脑电图(electroencephalogram,EEG)是从头皮或者大脑里面描记到的局部神经元进行的电活动。从20世纪的40年代开始以来,脑电图应用于临床,作为一种简便、易行、灵敏、无创的神经电生理学的检查方法,脑电图在临床上不仅可以监测出大脑的活动情况、而且还可以反映出神经细胞的功能状况,与此同时还可以评估出大脑的功能状态,对疾病的早期诊断、治疗及预后监测过程中起到重要的作用。本次研究应用脑电图仪分析长QT间期综合征患者的脑电图活动,了解长QT间期综合征患者的脑电图特点,探讨长QT间期综合征患者脑电图变化的临床意义。方法选取了2015年10月-2016年4月安徽医科大学第一附属医院收治的长QT间期综合征患者20例作为研究组,记录患者的临床资料,脑电图监测结果,心电图检查结果,QT间期以及QTc的数值。另外选取20例健康体检的人员作为对照组,记录受试者的临床资料以及脑电图监测结果。研究组中男性11例,女性9例,年龄39-80岁,平均(66.9土9.9)岁。健康对照组中男性11例,女性9例,年龄36-78岁,平均(60.6土10.4)岁。两组性别、年龄差异无统计学意义(P0.05)。对20例长QT间期综合征患者和20例健康者进行20导联脑电图检查,并进行对比分析。按照目前脑电图异常程度的诊断标准可以将脑电图分为四大类即为:正常的脑电图、轻度异常的脑电图、中度异常的脑电图、重度异常的脑电图。对研究组中的所有受试者均行12导联心电图检查,QT间期是从QRS波群的起始处到T波终点的这段距离,对于相同的患者可以选择相同的导联观察。假果T波末端很难发现的话,则可以另外选择从T波的下降支最陡峭处画一条切线,以切线和基线交点做为T波的末端。对于房颤的患者来说,因R-R间期绝对的不相同,选择最长R-R间期和最短R-R间期分别计算QTc的数值,然后取其平均值。QTc=QT/R-R,当QT0.44s时才考虑QT间期的延长,一般成人不会超过0.40s。使用SPSS17.0软件进行统计学分析。结果20例长QT间期综合征患者中有17例脑电图异常,异常率85%,对照组20例健康成人中有2例脑电图异常,异常率10%。两组比较差异有统计学意义(P0.05)。脑电异常表现为慢波(θ波和δ波)活动增多而快波(β波)及α波的减少,未发现有患者的脑电图显示有明显的癫痫样活动(棘波、棘-慢综合波)。结论长QT间期综合征患者的异常脑电图活动较健康对照组更为频繁,这个结果表明离子通道功能障碍导致心律失常与癫痫可能存在共同的发病机制。
[Abstract]:Objective long QT interval syndrome (LQTS), also known as repolarization delay syndrome, refers to prolonged QT interval on electrocardiogram, accompanied by abnormal shape of T wave and (or U) wave. The main clinical manifestation is ventricular arrhythmia, syncope.A group of syndrome associated with sudden death and seizures.Electroencephalograms (EGG) are the electrical activity of local neurons recorded in the scalp or brain.Since the 1940s, EEG has been used in clinical practice. As a simple, easy, sensitive and noninvasive method of nerve electrophysiology, EEG can not only monitor the brain activity in clinic.It can also reflect the function of nerve cells, at the same time, it can evaluate the functional state of brain, which plays an important role in the early diagnosis, treatment and prognosis monitoring of diseases.In this study, electroencephalogram (EEG) activity in patients with long QT interval syndrome (LQT) was analyzed, and the characteristics of EEG in patients with long QT interval syndrome (LQT) were analyzed, and the clinical significance of EEG changes in patients with LQT syndrome was discussed.Methods Twenty patients with long QT interval syndrome admitted in the first affiliated Hospital of Anhui Medical University from October 2015 to April 2016 were selected as the study group. The clinical data and EEG monitoring results were recorded.The results of electrocardiogram showed that the QT interval and the value of QTc.In addition, 20 healthy persons were selected as control group, and the clinical data and EEG monitoring results were recorded.The study group consisted of 11 males and 9 females, aged 39-80 years, with an average age of 66. 9 卤9. 9 years.In the healthy control group, there were 11 males and 9 females, aged 36 to 78 years, with an average of 60.6 卤10.4 years old.There was no significant difference in sex and age between the two groups (P 0.05).Electroencephalogram (EEG) of 20 patients with long QT interval syndrome and 20 healthy subjects were examined and compared.According to the diagnostic criteria of the degree of abnormal EEG at present, EEG can be divided into four categories: normal EEG, mild abnormal EEG, moderate abnormal EEG and severe abnormal EEG.All the subjects in the study group were examined by 12-lead electrocardiogram (12-lead electrocardiogram) and QT interval was the distance from the beginning of QRS wave group to the terminal point of T wave, and the same lead observation could be selected for the same patients.If the terminal of T wave is difficult to find, a tangent line can be drawn from the steepest descending branch of T wave, and the tangent line and the intersection point of baseline can be used as the end of T wave.For patients with atrial fibrillation, because the R-R interval is absolutely different, the longest R-R interval and the shortest R-R interval are selected to calculate the value of QTc, and then the average value.SPSS17.0 software was used for statistical analysis.Results there were 17 abnormal EEG in 20 patients with long QT interval syndrome, the abnormal rate was 85%, and 2 out of 20 healthy adults in the control group had abnormal EEG, the abnormal rate was 10%.The difference between the two groups was statistically significant (P 0.05).The abnormal EEG showed the increase of slow wave (胃 wave and 未 wave) and the decrease of fast wave (尾 wave) and 伪 wave.Conclusion abnormal EEG activity in patients with long QT interval syndrome is more frequent than that in healthy controls. The results suggest that arrhythmia and epilepsy may be caused by ion channel dysfunction.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R742.1;R541.7

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