Early post-convulsive prolongation of QT time in children
Early post-convulsive prolongation of QT time in children
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DOI：
10.1080/08035250510031025
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发表时间：
2005-09-01
期刊：
影响因子：
3.8
通讯作者：
Schneider, P
中科院分区：
文献类型：
--
作者：
Kändler, L;Fiedler, A;Schneider, P
目的：儿童癫痫发作的一个重要鉴别诊断是长 QT 综合征。儿童癫痫的发生率比长 QT 综合征高约 400 倍。我们观察到惊厥后 QT 间期轻微延长的儿童比报告的长 QT 综合征的发生率更常见。因此，我们进行了一项前瞻性研究来明确儿童惊厥后 QT 时间延长的特征。方法：我们连续调查了 30 名癫痫发作后 2 小时内的婴儿和儿童（3 个月至 14 岁）。 1-9 天后进行后续心电图检查。我们还获得了 30 名年龄和性别匹配的健康对照者的心电图。我们根据导联 II、V5、V6 中的 Bazett 公式计算了根据心率校正的 QT 间期 (QTc)、QT 离散度和切迹 T 波数量。结果：我们发现，30 名婴儿和儿童的第一次心电图中，有 7 名婴儿和儿童的一个或多个导联的 QTc 间期超过 440 毫秒，而在后续心电图中，30 名婴儿和儿童中只有 1 名（p = 0.0003），健康对照中 30 名婴儿和儿童中有 2 名（p = 0.14）。第一次心电图所有导联的平均 QTc 较高。这在导联 II（414 vs 402 ms，p = 0.008）、V5（416 vs 404 ms，p = 0.002）和 V6（415 vs 399 ms，p = 0.001）中具有统计学意义。与健康对照相比，惊厥后早期心电图的 QT 离散度稍大（36 毫秒 vs 31 毫秒，p = 0.03）。与惊厥后晚期心电图相比，切迹 T 波在惊厥后早期出现的频率更高 (p = 0.009)。结论：惊厥后 QT 间期轻度至中度延长在儿科患者中并不罕见，而是短暂的。
Aim: An important differential diagnosis of seizures in childhood is the long QT syndrome. Childhood epilepsy occurs about 400 times more often than long QT syndrome. We had observed children with slight post-convulsive prolongation of QT time more often than the reported incidence of long QT syndrome. We therefore conducted a prospective study to define the characteristics of post-convulsive prolongation of QT time in children. Methods: We investigated 30 consecutive infants and children ( 3 mo to 14 y) within 2 h after seizures. A follow-up ECG was obtained 1 - 9 d later. We also obtained ECGs from 30 healthy age- and gender-matched controls. We calculated the QT interval corrected for heart rate (QTc) by Bazett's formula in leads II, V5, V6, QT dispersion and the number of notched T waves. Results: We found a QTc interval of more than 440 ms in one or more leads in the first ECG in seven of 30 infants and children compared to 1 of 30 in the follow-up ECG (p = 0.0003) and two of 30 in the healthy controls (p = 0.14). Average QTc was higher for all leads in the first ECG. This was statistically significant in leads II ( 414 vs 402 ms, p = 0.008), V5 ( 416 vs 404 ms, p = 0.002) and V6 ( 415 vs 399 ms, p = 0.001). Compared to healthy controls, QT dispersion was slightly larger in the early post-convulsive ECG ( 36 vs 31 ms, p = 0.03). Notched T waves occurred more frequently in the early compared to the late post-convulsive ECGs ( p = 0.009).Conclusion: Slight to moderate post-convulsive prolongation of the QT interval is not rare but transient in paediatric patients.