老年医学与保健2017，Vol.23Issue(6)：477-480,4.
老年肝移植受者肝硬化心肌病的临床特征及预后分析
Clinical Features of Cirrhotic Cardiomyopathy in Elderly Liver Transplant Recipients and Prognosis Analysis
李剑 1张学铭 1郑莺 1乔志卿 1沈学东 1张建军 2沈节艳1
作者信息
- 1. 上海交通大学医学院附属仁济医院心血管内科,上海200127
- 2. 上海交通大学医学院附属仁济医院肝脏外科,上海200127
- 折叠
摘要
Abstract
Objective To investigate the prevalence,clinical features and prognosis of cirrhotic cardiomyopathy (CCM) in elderly liver transplant recipients.Methods Elderly liver transplant recipients (≥60 years old) with no other known cardiac diseases,who had received orthotopic liver transplantation within the period from January,2012 to June,2015 in Renji Hospital,were included in this study;based on the results of echocardiography and ECG,diagnosis of CCM was made to cirrhotic patients with systolic or diastolic dysfunction while diagnosis of QTc interval prolongation was made to patients with QTc interval ＞440 ms;all the patients were followed up.Results A total of 63 elderly patients,aged at (64±9) years old,mostly male (75％),were included,27 patients (43％) with the diagnosis of CCM and 29 patients (46％) with the diagnosis of QTc interval prolongation;compared with patients with normal QTc interval,patients with QTc interval prolongation had higher Child-Pugh score (P=0.003),MELD score (P =0.008),serum bile acid (P=0.01),bilirubin (P=0.007) and INR (P=0.02) but a lower fibrinogen (P=0.04).MELD score was independently related to QTc length (R=0.32,R2=0.1,P=0.007);postoperative follow-up lasted for (24.7 ± 10.3) months;Compared with patients,Kaplan-Meier survival curve showed a lower survival rate in patients with prolonged QTc interval than in patients with normal QTc interval (P=0.047,HR2.69).Conclusions The prevalence of CCM and QTc interval prolongation in elderly liver transplant recipients was 43 ％ and 46％ respectively;patients with QTc interval prolongation have more serious liver disease and poorer prognosis.关键词
老年/肝移植/肝硬化心肌病/QTc间期延长Key words
elderly/liver transplantation/cirrhotic cardiomyopathy (CCM)/QTc interval prolongation引用本文复制引用
李剑,张学铭,郑莺,乔志卿,沈学东,张建军,沈节艳..老年肝移植受者肝硬化心肌病的临床特征及预后分析[J].老年医学与保健,2017,23(6):477-480,4.
