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目的探讨手足口病(HFMD)患儿校正QT间期离散度(QTcd)测定的临床意义及其与心肌肌钙蛋白T(cTnT)的相关性。方法选择HFMD患儿100例为研究组,随机匹配98例健康儿童为对照组。所有入选对象均描记12导联同步体表心电图,用心率校正得QTcd,同时行cTnT定量检测。cTnT阳性组按预后分为病情好转组与病情加重组,均于治疗第7 d复查心电图、cTnT。结果治疗前cTnT阳性组QTcd、cTnT大于阴性组、对照组(P均<0.05),阴性组大于对照组(P<0.05);治疗前病情加重组QTcd、cTnT大于病情好转组(P<0.05),病情好转组治疗后QTcd、cTnT较治疗前降低(P<0.05),而病情加重组治疗后则上升(P<0.05);QTcd与cTnT值呈正相关(r=0.802,P=0.000)。结论早期动态监测QTcd的变化有助于HFMD患儿心肌损害的早期诊断和治疗。
Objective To investigate the clinical significance of corrected QT dispersion (QTcd) in children with hand-foot-mouth disease (HFMD) and its correlation with cardiac troponin T (cTnT). Methods 100 children with HFMD were selected as the research group and randomly matched 98 healthy children as the control group. All subjects were recorded 12-lead synchronous body surface ECG, heart rate corrected QTcd, while cTnT quantitative detection. According to the prognosis, cTnT positive group was divided into improved condition group and exacerbation group, all of which were examined ECG on the 7th day of treatment, cTnT. Results Before treatment, QTcd and cTnT in cTnT positive group were significantly higher than those in negative group and control group (P <0.05), and negative group was higher than that in control group (P <0.05) , QTcd and cTnT were lower in treatment group than those before treatment (P <0.05), while those in exacerbation group were increased after treatment (P <0.05). There was a positive correlation between QTcd and cTnT (r = 0.802, P = 0.000). Conclusion The early dynamic monitoring of QTcd changes is helpful for the early diagnosis and treatment of myocardial damage in children with HFMD.