Tip 1 diyabetes mellituslu çocuklar ve adölesanlarda P dalga dispersiyonu, QT intervali, QT dispersiyonu, QTC ve QTC dispersiyonunun otonomik fonksiyon bozukluğunun erken tanısındaki rolünün değerlendirilmesi
Loading...
Date
2011
Authors
Özboyacı, Evren
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Bu çalışmada, Tip 1 Diyabetes Mellituslu (Tip 1 DM) çocuk ve adölesanlarda diyabetin neden olduğu kardiyak otonomik fonksiyon bozukluğunun (KOFB) erken tanısında, p dalga dispersiyonu (Pd), QT intervali, QT dispersiyonu (QTd), QTc ve QTc dispersiyonunun (QTcd) duyarlılığının saptanması ve bu değerlerin başta diyabet süresi olmak üzere bazı belirteçlerle ilişkisinin araştırılması amaçlandı.Çalışmaya Haziran 2009 - Haziran 2010 yılları arasında Uludağ Üniversitesi Tıp Fakültesi Çocuk Endokrin Polikliniğine başvuran, Tip 1 DM tanısı almış, 150 çocuk ve adölesan ile kontrol grubu olarak çocuk kardiyoloji polikliniğinde masum üfürüm tanısı alan 100 sağlıklı çocuk ve adölesan alındı. Tüm vakalara elektrokardiyografi (EKG) çekilerek, kalp hızı, Pd, QT, QTd, QTc ve QTcd hesaplandı. Hastaların yaş, cinsiyet, tanı yaşı, diyabetik olma süresi, HbA1c düzeyleri gibi klinik ve demografik özellikleri incelendi ve bu özelliklerin Pd, QT, QTd, QTc ve QTcd üzerine etkileri araştırıldı.Hasta ve kontrol grubu arasında yaş ve cinsiyet açısından fark yoktu. İzlem sürelerine göre; Grup 1, 2 ve 3'te QTd ve QTcd, izlemdeki HbA1c düzeylerine göre; Grup 2 ve 3'te QTd ve QTcd, izlemdeki kan şekeri düzeylerine göre; Grup 2 ve 3'te QTd ve QTcd kontrol grubuna göre daha yüksek saptandı. Çalışmamızda literatürle uyumlu olarak Tip 1 DM'li çocuklarda Pd anlamlı şekilde daha yüksek saptandı.Sonuç olarak; Tip 1DM'de KOFB, hastalığın herhangi bir döneminde ortaya çıkabilir ve ciddi morbidite ve mortaliteye neden olabilir. Bu olgularda EKG değerlendirilmesiyle semptomlar ortaya çıkmadan KOFB tanısı konabilir. Bizim hastalarımızda da literatürle uyumlu olarak, KOFB semptomu olmayan diyabetik hastalarda kontrole göre Pd, QT, QTd, QTc ve QTcd anlamlı şekilde yüksek bulunmuştur.
In this study, it was aimed to determine the sensitivity of p wave dispersion (Pd), QT interval, QT dispersion (QTd), QTc and QTC dispersion (QTcd) in early diagnosis of cardiac autonomic function disorder (CAFD) that was caused by diabetes in children and adolescents with type-1 Diabetes Mellitus (Type 1 DM) and to evaluate the association between these measures and other markers such as duration of diabetes.A total of 150 children and adolescents admitted to Pediatric Endocrinology Department between June 2009 and June 2010 with Type 1 DM diagnosis and a control group consisting of 100 healthy children and adolescents with silent murmur admitted to Pediatric Cardiology Department were enrolled to this study. Electrocardiography (ECG) was performed in all cases and heart rate, Pd, QT, QTd, QTc and QTcd were calculated. The clinical and demographic features such as age, gender, age at admission, HbA1c levels of the patients were examined and the effects of these measures on Pd, QT, QTd, QTc, and QTcd were investigated.There were no differences between the patient and control groups in terms of age and gender. According to the duration of follow-up, QTd and QTcd in groups 1, 2 and 3, according to HbA1c levels during follow-up QTd and QTcd in groups 2 and 3, according to blood glucose levels Qtd and QTcd in groups 2 and 3 were found to be sighificantly higher than the control group. In agreement with the literature, Pd was found to be significantly higher in children with Type-1 DM in our study.Conclusion CAFD may develop in the course of Type-1 DM and may cause to significant morbidity and mortality. CAFD can be diagnosed with ECG in these cases before the development of symptoms. In our patients, in agreement with the literature, Pd, QT, QTd, QTc and QTcd were found to be significantly higher in patients without CAFD symptoms compared with the controls.
In this study, it was aimed to determine the sensitivity of p wave dispersion (Pd), QT interval, QT dispersion (QTd), QTc and QTC dispersion (QTcd) in early diagnosis of cardiac autonomic function disorder (CAFD) that was caused by diabetes in children and adolescents with type-1 Diabetes Mellitus (Type 1 DM) and to evaluate the association between these measures and other markers such as duration of diabetes.A total of 150 children and adolescents admitted to Pediatric Endocrinology Department between June 2009 and June 2010 with Type 1 DM diagnosis and a control group consisting of 100 healthy children and adolescents with silent murmur admitted to Pediatric Cardiology Department were enrolled to this study. Electrocardiography (ECG) was performed in all cases and heart rate, Pd, QT, QTd, QTc and QTcd were calculated. The clinical and demographic features such as age, gender, age at admission, HbA1c levels of the patients were examined and the effects of these measures on Pd, QT, QTd, QTc, and QTcd were investigated.There were no differences between the patient and control groups in terms of age and gender. According to the duration of follow-up, QTd and QTcd in groups 1, 2 and 3, according to HbA1c levels during follow-up QTd and QTcd in groups 2 and 3, according to blood glucose levels Qtd and QTcd in groups 2 and 3 were found to be sighificantly higher than the control group. In agreement with the literature, Pd was found to be significantly higher in children with Type-1 DM in our study.Conclusion CAFD may develop in the course of Type-1 DM and may cause to significant morbidity and mortality. CAFD can be diagnosed with ECG in these cases before the development of symptoms. In our patients, in agreement with the literature, Pd, QT, QTd, QTc and QTcd were found to be significantly higher in patients without CAFD symptoms compared with the controls.
Description
Keywords
Tip1 diyabetes mellitus, Kardiyak otonomik fonksiyon bozukluğu, P dalga dispersiyonu, QT dispersiyonu, Çocuklar, Type1 diabetes mellitus, Cardiac autonomic dsyfunction, P wave dispersion, QT dispersion, Children
Citation
Özboyacı, E. (2011). Tip 1 diyabetes mellituslu çocuklar ve adölesanlarda P dalga dispersiyonu, QT intervali, QT dispersiyonu, QTC ve QTC dispersiyonunun otonomik fonksiyon bozukluğunun erken tanısındaki rolünün değerlendirilmesi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.