The Journal of Shahid Sadoughi University of Medical Sciences
مجله علمي پژوهشي دانشگاه علوم پزشكي شهید صدوقی يزد
JSSU
Medical Sciences
http://jssu.ssu.ac.ir
20
journal20
2228-5741
2228-5733
fa
jalali
1405
6
1
gregorian
2026
9
1
34
6
online
1
fulltext
fa
بررسی فاصله QT در کودکان کمخطر مبتلا به درد قفسهسینه مراجعهکننده به درمانگاه تخصصی اطفال بیمارستان امیرالمؤمنین (ع) سمنان طی سالهای ۱۴۰2–۱۴۰1
Evaluation of QT Interval Status in Low-Risk Children Presenting with Chest Pain During 2022–2023: A Cross-Sectional Study
اطفال
Pediatrics
پژوهشي
Original article
<div style="text-align: justify;"><span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:115%"><span style="font-family:Aptos,sans-serif"><b><span lang="AR-SA" style="line-height:115%"><span b="" nazanin="" style="font-family:">مقدمه</span></span></b><span lang="AR-SA" style="line-height:115%"><span b="" nazanin="" style="font-family:">: درد قفسهسینه از شکایات شایع کودکان است و اغلب منشأ غیرقلبی دارد؛ با این حال، احتمال هرچند نادر آریتمیهای خطرناک و مرگ ناگهانی، انجام ارزیابی دقیق را ضروری میسازد. اندازهگیری فاصله</span></span><span dir="LTR" lang="EN-GB" style="font-size:13.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""> QT </span></span></span><span lang="AR-SA" style="line-height:115%"><span b="" nazanin="" style="font-family:">در </span></span><span dir="LTR" lang="EN-GB" style="font-size:13.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""> ECG</span></span></span><span lang="AR-SA" style="line-height:115%"><span b="" nazanin="" style="font-family:">از شاخصهای مهم در ارزیابی اولیه محسوب میشود. این مطالعه با هدف بررسی وضعیت فاصله</span></span><span dir="LTR" lang="EN-GB" style="font-size:13.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""> QT </span></span></span><span lang="AR-SA" style="line-height:115%"><span b="" nazanin="" style="font-family:">و تعیین ارتباط آن با ویژگیهای بالینی کودکان مراجعهکننده با درد قفسهسینه انجام شد</span></span><span dir="LTR" lang="EN-GB" style="font-size:13.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">.</span></span></span><span lang="AR-SA" style="line-height:115%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:115%"><span style="font-family:Aptos,sans-serif"><b><span lang="AR-SA" style="line-height:115%"><span b="" nazanin="" style="font-family:">روش کار</span></span></b><span lang="AR-SA" style="line-height:115%"><span b="" nazanin="" style="font-family:">: در این مطالعه مقطعی، </span></span><span lang="FA" style="line-height:115%"><span b="" nazanin="" style="font-family:">۸۰</span></span> <span lang="AR-SA" style="line-height:115%"><span b="" nazanin="" style="font-family:">کودک </span></span><span lang="FA" style="line-height:115%"><span b="" nazanin="" style="font-family:">۵</span></span> <span lang="AR-SA" style="line-height:115%"><span b="" nazanin="" style="font-family:">تا </span></span><span lang="FA" style="line-height:115%"><span b="" nazanin="" style="font-family:">۱۴</span></span> <span lang="AR-SA" style="line-height:115%"><span b="" nazanin="" style="font-family:">ساله که طی سالهای </span></span><span lang="FA" style="line-height:115%"><span b="" nazanin="" style="font-family:">۱۴۰۱</span></span><span lang="FA" style="line-height:115%"><span new="" roman="" style="font-family:" times="">–</span></span><span lang="FA" style="line-height:115%"><span b="" nazanin="" style="font-family:">۱۴۰۲</span></span> <span lang="AR-SA" style="line-height:115%"><span b="" nazanin="" style="font-family:">بهدلیل درد شدید قفسهسینه به درمانگاه اطفال بیمارستان امیرالمؤمنین (ع) سمنان مراجعه کرده بودند، وارد مطالعه شدند. بیماران دارای بیماری قلبی شناختهشده یا مصرفکننده داروهای مؤثر بر</span></span><span dir="LTR" lang="EN-GB" style="font-size:13.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""> QT </span></span></span><span lang="AR-SA" style="line-height:115%"><span b="" nazanin="" style="font-family:">از مطالعه حذف شدند. اطلاعات دموگرافیک و نوار قلب ثبت گردید و فاصله</span></span><span dir="LTR" lang="EN-GB" style="font-size:13.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""> QT </span></span></span><span lang="AR-SA" style="line-height:115%"><span b="" nazanin="" style="font-family:">با روش استاندارد اندازهگیری شد. تحلیل دادهها با نرمافزار</span></span><span dir="LTR" lang="EN-GB" style="font-size:13.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""> SPSS </span></span></span><span lang="AR-SA" style="line-height:115%"><span b="" nazanin="" style="font-family:">نسخه </span></span><span lang="FA" style="line-height:115%"><span b="" nazanin="" style="font-family:">۲۴</span></span> <span lang="AR-SA" style="line-height:115%"><span b="" nazanin="" style="font-family:">انجام گرفت</span></span><span dir="LTR" lang="EN-GB" style="font-size:13.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">.</span></span></span><span lang="AR-SA" style="line-height:115%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:115%"><span style="font-family:Aptos,sans-serif"><b><span lang="AR-SA" style="line-height:115%"><span b="" nazanin="" style="font-family:">یافتهها:</span></span></b><span lang="AR-SA" style="line-height:115%"><span b="" nazanin="" style="font-family:"> میانگین فاصله</span></span><span dir="LTR" lang="EN-GB" style="font-size:13.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""> QT </span></span></span><span lang="AR-SA" style="line-height:115%"><span b="" nazanin="" style="font-family:">برابر با</span></span><span b="" lang="AR-SA" nazanin="" style="font-family:"> 026/0 </span><span cambria="" lang="AR-SA" style="font-family:">±</span><span b="" lang="AR-SA" nazanin="" style="font-family:">376/0 ثانیه</span><span lang="AR-SA" style="line-height:115%"><span b="" nazanin="" style="font-family:"> بود و ۹۵ درصد مقادیر در محدوده طبیعی و ۵ درصد آنها در محدوده مرزی قرار داشتند. هیچ ارتباط آماری معناداری میان فاصله</span></span><span dir="LTR" lang="EN-GB" style="font-size:13.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""> QT </span></span></span><span lang="AR-SA" style="line-height:115%"><span b="" nazanin="" style="font-family:">و سن، جنس، وزن، سابقه خانوادگی بیماری قلبی، مصرف دارو یا سابقه بیماری مشاهده نشد</span></span><span dir="LTR" lang="EN-GB" style="font-size:13.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""> (P>0.05).</span></span></span><span lang="AR-SA" style="line-height:115%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:115%"><span style="font-family:Aptos,sans-serif"><b><span lang="AR-SA" style="line-height:115%"><span b="" nazanin="" style="font-family:">نتیجهگیری:</span></span></b><span lang="AR-SA" style="line-height:115%"><span b="" nazanin="" style="font-family:"> نتایج این مطالعه نشان داد که در کودکان کمخطر مبتلا به درد قفسهسینه، تغییرات قابلتوجهی در فاصله </span></span><span dir="LTR" lang="EN-GB" style="font-size:13.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">QT</span></span></span> <span lang="AR-SA" style="line-height:115%"><span b="" nazanin="" style="font-family:">وجود ندارد و تمامی مقادیر در محدوده طبیعی باقی میمانند. بر این اساس، اندازهگیری </span></span><span dir="LTR" lang="EN-GB" style="font-size:13.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">QT</span></span></span> <span lang="AR-SA" style="line-height:115%"><span b="" nazanin="" style="font-family:">در این گروه ارزش تشخیصی محدودی دارد و به نظر میرسد تمرکز بر شرححال دقیق، علائم همراه و سابقه خانوادگی میتواند اثربخشی بیشتری در هدایت تصمیمگیری بالینی داشته باشد.</span></span><span lang="FA" style="line-height:115%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br>
</div>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="line-height:115%"><span style="font-family:Aptos,sans-serif"><b><span lang="EN-GB" style="font-size:11.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">Introduction</span></span></span></b><span dir="RTL" lang="AR-SA" style="font-size:11.0pt"><span style="line-height:115%"><span b="" nazanin="" style="font-family:">:</span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="line-height:115%"><span style="font-family:Aptos,sans-serif"><span lang="EN-GB" style="font-size:11.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">Chest pain is a common complaint among children and is usually non-cardiac in origin. Nevertheless, due to the rare possibility of malignant arrhythmias or sudden cardiac death, careful evaluation is essential. QT interval measurement on electrocardiography (ECG) is considered an important parameter in the initial assessment. This study aimed to evaluate QT interval characteristics and their clinical associations in low-risk pediatric patients presenting with chest pain.</span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="line-height:115%"><span style="font-family:Aptos,sans-serif"><b><span lang="EN-GB" style="font-size:11.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">Methods:</span></span></span></b></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="line-height:115%"><span style="font-family:Aptos,sans-serif"><span lang="EN-GB" style="font-size:11.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">In this cross-sectional study, 80 children aged 5–14 years who presented with significant chest pain to the pediatric clinic of Amir al-Momenin Hospital (Semnan, Iran) during 2022–2023 were enrolled. Children with known cardiac disease or taking QT-modifying medications were excluded. Demographic data and standard 12-lead ECGs were collected, and QT intervals were measured using established manual protocols. Statistical analyses were performed using SPSS version 24.</span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="line-height:115%"><span style="font-family:Aptos,sans-serif"><b><span lang="EN-GB" style="font-size:11.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">Results:</span></span></span></b></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="line-height:115%"><span style="font-family:Aptos,sans-serif"><span lang="EN-GB" style="font-size:11.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">The mean QT interval was 0.376 ± 0.026 seconds, with all values falling within the normal physiological range. No statistically significant associations were found between QT interval and age, sex, weight, family history of cardiac disease, medication use, or history of comorbid conditions (P > 0.05).</span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="line-height:115%"><span style="font-family:Aptos,sans-serif"><b><span lang="EN-GB" style="font-size:11.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">Conclusions</span></span></span></b><span lang="EN-GB" style="font-size:11.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">:</span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="line-height:115%"><span style="font-family:Aptos,sans-serif"><span lang="EN-GB" style="font-size:11.0pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times="">The findings indicate that in low-risk children presenting with chest pain, QT interval abnormalities are uncommon and measured values remain within normal limits. Routine QT assessment in this population appears to have limited diagnostic value. Greater emphasis should instead be placed on detailed clinical history, associated symptoms, and relevant family risk factors to guide clinical decision-making.</span></span></span><span dir="RTL" lang="AR-SA" style="font-size:11.0pt"><span style="background:yellow"><span style="line-height:115%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br>
QTطولانی, درد قفسه سینه, الکتروکاردیوگرافی, اطفال
Long QT Syndrome, Chest Pain, Electrocardiography, Pediatrics
10358
10365
http://jssu.ssu.ac.ir/browse.php?a_code=A-10-5563-2&slc_lang=fa&sid=1
Soodeh
Hooshmandi
سوده
هوشمندی
s.Hooshmandi12@gmail.com