缺铁性贫血对孕中期孕妇心电图的影响研究
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摘要
目的利用心电图(ECG)检测并比较缺铁性贫血孕中期孕妇和健康孕中期孕妇的心肌功能,以分析缺铁性贫血对孕中期心肌功能的影响。方法选择2015年12月至2017年12月来该院就诊的110例孕中期(孕周为13～27周)孕妇,对照组为55例健康孕中期孕妇,研究组为55例贫血孕中期孕妇,采用Sysmex XE-2100全自动五分类血液分析仪和西门子Advia XP分析仪检测两组的血液学参数和生化指标,ECG检测并评估两组孕妇的心肌功能。结果研究组的QRS间期明显降低(P<0.05),QTc间期明显增高(P<0.05),Ⅱ、Ⅲ、AVF导联和V2～V4导联出现T波异常低平和负性T波,其频率明显增高(P<0.05);研究组中92%患者均出现心动过速和ECG异常。结论缺铁性贫血可导致孕中期ECG各种异常改变。
Objective To use the electrocardiogram(ECG)examination and to compare the myocardial function between the pregnant women with iron deficiency anemia and healthy pregnant women in the second trimester of pregnancy in order to analyze the effect of iron deficiency on the myocardial function in second trimester of pregnancy.Methods A total of 110 pregnant women in the second trimester of pregnancy(13-27 gestational weeks)in this hospital from Dec.2015 to Dec.2017 were selected,55 healthy pregnant women in the control group and 55 anemia pregnant women in the study group.The hematological parameters and biochemical indicators were detected by using the Sysmex XE-2100 automatic five categories hematological analyzer and Siemens Advia XP analyzer.Electrocardiogram was performed and the myocardial function in the two groups was evaluated.Results The QRS interval in the study group was significantly reduced(P<0.05),the QT interval(QTc)was significantly prolonged(P<0.05).The T-wave abnormal flatness and negative Twaves in leadⅡ,Ⅲ,AVF and V2-V4 appeared with increased frequency(P<0.05).92% of cases in the study group appeared tachycardia and ECG abnormalities.Conclusion Iron deficiency anemia could cause various abnormal changes of ECG in the second trimester of pregnancy.
Objective To use the electrocardiogram(ECG)examination and to compare the myocardial function between the pregnant women with iron deficiency anemia and healthy pregnant women in the second trimester of pregnancy in order to analyze the effect of iron deficiency on the myocardial function in second trimester of pregnancy.Methods A total of 110 pregnant women in the second trimester of pregnancy(13-27 gestational weeks)in this hospital from Dec.2015 to Dec.2017 were selected,55 healthy pregnant women in the control group and 55 anemia pregnant women in the study group.The hematological parameters and biochemical indicators were detected by using the Sysmex XE-2100 automatic five categories hematological analyzer and Siemens Advia XP analyzer.Electrocardiogram was performed and the myocardial function in the two groups was evaluated.Results The QRS interval in the study group was significantly reduced(P<0.05),the QT interval(QTc)was significantly prolonged(P<0.05).The T-wave abnormal flatness and negative Twaves in leadⅡ,Ⅲ,AVF and V2-V4 appeared with increased frequency(P<0.05).92% of cases in the study group appeared tachycardia and ECG abnormalities.Conclusion Iron deficiency anemia could cause various abnormal changes of ECG in the second trimester of pregnancy.
引文
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[2]EBNER N,JANKOWSKA E A,PONIKOWSKI P,et al.The impact of Iron deficiency and anaemia on exercise capacity and outcomes in patients with chronic heart failure.Results from the studies investigating co-morbidities aggravating heart failure[J].Int J Cardiol,2016,205(1):6-12.
[3]SHARMA J B,BUMMA S D,SAXENA R,et al.Cross sectional,comparative study of serum erythropoietin,transferrin receptor,ferritin levels and other hematological indices in normal pregnancies and Iron deficiency anemia during pregnancy[J].Eur J Obstet Gynecol Reprod Biol,2016,203(1):99-103.
[4]KHUMRIN P,SRISUWAN P,LERTPRAYOONMITW,et al.Effective ECG reference ranges for Northern Thai People[J].Heart Asia,2015,7(1):32-40.
[5]O′MEARA E,MURPHY C,MCMURRAY J J.Anemia and heart failure[J].Curr Heart Fail Rep,2004,1(4):176-182.
[6]ABDELRAHMAN E G,GASIM G I,MUSA I R,et al.Red blood cell distribution width and Iron deficiency anemia among pregnant Sudanese women[J].Diagn Pathol,2012,7(1):168.
[7]SHARMA R,KUMAR A,ANEJA G K.Serial changes in pulmonary hemodynamics during pregnancy:a non-invasive study using doppler echocardiography[J].Cardiol Res,2016,7(1):25-31.
[8]ANAND I S.Anemia and chronic heart failure implications and treatment options[J].J Am Coll Cardiol,2008,52(7):501-511.
[9]GV S,PK S,HERUR A,et al.Correlation between haemoglobin level and electrocardiographic(ECG)findings in anaemia:a cross-sectional study[J].J Clin Diagn Res,2014,8(4):BC04-BC06.
[10]ZAMANI M,ESMAILIAN M L,YOOSEFIAN Z.QT interval in pregnant and non-pregnant women[J].Emerg(Tehran),2014,2(1):22-25.
[11]PEREIRA A,SARNAK M.Anemia as a risk factor for cardiovascular disease[J].Kidney Int Suppl,2003,20(87):S32-S39.
[12]M S,S C,BRID S V.Electrocradiographic Qrs axis,Qwave and t-wave changes in 2nd and 3rd trimester of normal pregnancy[J].J Clin Diagn Res,2014,8(9):BC17-BC21.
[13]NIEMEIJER M N,VAN DEN BERG M E,EIJGELSHEIMM,et al.Pharmacogenetics of drug-induced QT interval prolongation:an update[J].Drug Safety,2015,38(10):855-867.