探讨慢性肾脏病(CKD)5期住院患者心电图QT间期延长相关的临床特征及影响因素。

回顾性收集2018年1月至2018年12月在我院肾内科住院的CKD5期患者的临床资料。根据预先制定的标准纳入患者，按照稳定状态下患者心电图校正的QT间期(QTc)是否延长分为QTc延长组和正常组。比较两组患者的临床特征并分析QTc延长的相关因素。采用Logistic回归方法分析CKD5期住院患者QTc延长的影响因素。

共纳入310例患者，男性178例(57.4%)，女性132例(42.6%)，年龄[53(41，62)]岁，其中QTc延长组130例，正常组180例。与正常组相比，QTc延长组年龄偏大，合并感染、进入透析的患者所占比例更高，白蛋白、高密度脂蛋白胆固醇(HDL-C)、血钾和校正血钙数值更低，二氧化碳结合力水平更高，心脏彩超提示左室EF值更低、左房内径更大。两组患者的性别比例、高血压发生率、冠心病发生率、糖尿病发生率、血红蛋白、磷、镁、低密度脂蛋白胆固醇(LDL-C)水平、心脏彩超左室内径数值比较均无统计学差异。Logistic回归分析结果显示，低钙血症、血钾≤4.0 mmol/L和进入透析阶段是该疾病人群QTc延长的独立危险因素。

CKD5期住院患者心电图QTc延长比例较高；低钙血症、血钾≤4.0 mmol/L和已进入透析阶段是该疾病人群QT间期延长的独立危险因素。

To explore the clinical characteristics and influencing factors of ECG QT interval prolongation in hospitalized patients with CKD stage 5.

Clinical data of the hospitalized patients with CKD stage 5 in the Department of Nephrology of the Second Hospital of Shanxi Medical University were collected retrospectively from January to December, 2018. By the pre-established criteria, the patients were divided into QTc prolongation group and normal group according to whether the QTc interval, which was corrected by the patient′s ECG in the stable state, was prolonged or not. The clinical characteristics of the two groups were compared and the related factors of QTc prolongation were analyzed. Logistic regression method was used to analyze the influencing factors of QTc prolongation in the patients.

A total of 310 patients were enrolled, including 178 males (57.4%) and 132 females (42.6%), among whom 130 cases were in the QTc prolongation group and 180 cases in the normal group. Compared with patients in the normal group, patients in the QTc prolongation group had higher age, higher proportion of infection and dialysis, lower values of serum albumin, HDL-C, potassium, and corrected calcium, together with higher level of the binding capacity of carbon dioxide. Color Doppler echocardiography showed that the left ventricular EF value was lower and the left atrial inner diameter was larger in the QTc prolongation group than in the normal group. There were no significant differences between the two groups in gender ratio, incidence of hypertension, incidence of coronary heart disease, incidence of diabetes, levels of hemoglobin, phosphorus, magnesium, LDL-C, and left ventricular inner diameter. Multivariate logistic regression analysis showed that hypocalcemia, serum potassium ≤4.0 mmol/L, and entering the stage of dialysis were the independent risk factors for prolonged QTc in the hospitalized patients with CKD stage 5.

The proportion of prolonged QTc of ECG in the hospitalized patients with CKD stage 5 was high. Hypocalcemia, serum potassium ≤4.0 mmol/L, and entering the stage of dialysis were independent risk factors for the prolonged QTc in the hospitalized patients with CKD stage 5.