本文選題：腦電圖 + 長(zhǎng)QT間期綜合征�。� 參考：《安徽醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的長(zhǎng)QT間期綜合征(LQTS)又稱復(fù)極延遲綜合征,是指心電圖上QT間期延長(zhǎng),并且伴有T波與(或者)U波的形態(tài)異常,臨床上主要表現(xiàn)為室性心律失常、暈厥、猝死以及癲癇發(fā)作的一組綜合征。腦電圖(electroencephalogram,EEG)是從頭皮或者大腦里面描記到的局部神經(jīng)元進(jìn)行的電活動(dòng)。從20世紀(jì)的40年代開始以來,腦電圖應(yīng)用于臨床,作為一種簡(jiǎn)便、易行、靈敏、無創(chuàng)的神經(jīng)電生理學(xué)的檢查方法,腦電圖在臨床上不僅可以監(jiān)測(cè)出大腦的活動(dòng)情況、而且還可以反映出神經(jīng)細(xì)胞的功能狀況,與此同時(shí)還可以評(píng)估出大腦的功能狀態(tài),對(duì)疾病的早期診斷、治療及預(yù)后監(jiān)測(cè)過程中起到重要的作用。本次研究應(yīng)用腦電圖儀分析長(zhǎng)QT間期綜合征患者的腦電圖活動(dòng),了解長(zhǎng)QT間期綜合征患者的腦電圖特點(diǎn),探討長(zhǎng)QT間期綜合征患者腦電圖變化的臨床意義。方法選取了2015年10月-2016年4月安徽醫(yī)科大學(xué)第一附屬醫(yī)院收治的長(zhǎng)QT間期綜合征患者20例作為研究組,記錄患者的臨床資料,腦電圖監(jiān)測(cè)結(jié)果,心電圖檢查結(jié)果,QT間期以及QTc的數(shù)值。另外選取20例健康體檢的人員作為對(duì)照組,記錄受試者的臨床資料以及腦電圖監(jiān)測(cè)結(jié)果。研究組中男性11例,女性9例,年齡39-80歲,平均(66.9土9.9)歲。健康對(duì)照組中男性11例,女性9例,年齡36-78歲,平均(60.6土10.4)歲。兩組性別、年齡差異無統(tǒng)計(jì)學(xué)意義(P0.05)。對(duì)20例長(zhǎng)QT間期綜合征患者和20例健康者進(jìn)行20導(dǎo)聯(lián)腦電圖檢查,并進(jìn)行對(duì)比分析。按照目前腦電圖異常程度的診斷標(biāo)準(zhǔn)可以將腦電圖分為四大類即為:正常的腦電圖、輕度異常的腦電圖、中度異常的腦電圖、重度異常的腦電圖。對(duì)研究組中的所有受試者均行12導(dǎo)聯(lián)心電圖檢查,QT間期是從QRS波群的起始處到T波終點(diǎn)的這段距離,對(duì)于相同的患者可以選擇相同的導(dǎo)聯(lián)觀察。假果T波末端很難發(fā)現(xiàn)的話,則可以另外選擇從T波的下降支最陡峭處畫一條切線,以切線和基線交點(diǎn)做為T波的末端。對(duì)于房顫的患者來說,因R-R間期絕對(duì)的不相同,選擇最長(zhǎng)R-R間期和最短R-R間期分別計(jì)算QTc的數(shù)值,然后取其平均值。QTc=QT/R-R,當(dāng)QT0.44s時(shí)才考慮QT間期的延長(zhǎng),一般成人不會(huì)超過0.40s。使用SPSS17.0軟件進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果20例長(zhǎng)QT間期綜合征患者中有17例腦電圖異常,異常率85%,對(duì)照組20例健康成人中有2例腦電圖異常,異常率10%。兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。腦電異常表現(xiàn)為慢波(θ波和δ波)活動(dòng)增多而快波(β波)及α波的減少,未發(fā)現(xiàn)有患者的腦電圖顯示有明顯的癲癇樣活動(dòng)(棘波、棘-慢綜合波)。結(jié)論長(zhǎng)QT間期綜合征患者的異常腦電圖活動(dòng)較健康對(duì)照組更為頻繁,這個(gè)結(jié)果表明離子通道功能障礙導(dǎo)致心律失常與癲癇可能存在共同的發(fā)病機(jī)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 鹵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 鹵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 偽 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.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R742.1;R541.7

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