日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

Online ISSN: 2187-2988 Print ISSN: 0911-1794
特定非営利活動法人日本小児循環器学会 Japanese Society of Pediatric Cardiology and Cardiac Surgery
〒162-0801東京都新宿区山吹町358-5アカデミーセンター Japanese Society of Pediatric Cardiology and Cardiac Surgery Academy Center, 358-5 Yamabuki-cho, Shinju-ku, Tokyo 162-0801, Japan
Pediatric Cardiology and Cardiac Surgery 37(1): 29-34 (2021)
doi:10.9794/jspccs.37.29

原著Original

学校心臓検診におけるQT延長スクリーニングを自動計測値で行うための抽出基準値に関する検討Reference Values for the Automatic Screening of QT Prolongation in School Cardiac Examinations

1鹿児島市立病院小児科Kagoshima City Hospital, Department of Pediatrics ◇ Kagoshima, Japan

2鹿児島市心臓検診委員会Kagoshima City Cardiac Screening Committee ◇ Kagoshima, Japan

3鹿児島大学病院小児科Kagoshima University Hospital, Department of Pediatric ◇ Kagoshima, Japan

4国立病院機構鹿児島医療センター小児科National Hospital Organization Kagoshima Medical Center, Department of Pediatrics ◇ Kagoshima, Japan

受付日:2020年10月9日Received: October 9, 2020
受理日:2020年12月21日Accepted: December 21, 2020
発行日:2021年4月1日Published: April 1, 2021
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背景:心拍数で補正されたQT時間(QTc)は自動計測のほうがマニュアル計測より長い.学校心臓検診でQT延長をスクリーニングする基準値はマニュアル計測で作成されており,自動計測で使用するとスクリーニング過多となる.

方法: 2009年から2013年に鹿児島市で学校心臓検診を受けた,小1・中1全員の心電図記録を後方視的に解析した.自動計測QTc値がマニュアル抽出基準値を超えた対象でマニュアル計測を行い,実際にマニュアル抽出基準値を超えている対象を抽出した.抽出された対象の自動計測QTc値を参考に基準値を考案した.

結果:対象者は総数54,586名,マニュアル計測対象者は1,233名(2.3%)であった.そのうちマニュアル抽出基準値を超えていたのは52名(0.10%)で,それらの自動計測QTc最低値は男女別にそれぞれ小1が445 msと447 ms,中1が463 msと451 msであった.

結論:学校心臓検診のFridericia補正による自動計測QTc基準値は,学年毎に男女共通でそれぞれ小1で445 ms,中1で450 msが妥当と考えられた.

Background: The heart-rate–corrected QT interval (QTc) by automatic measurements is longer than that by manual measurements. The reference QTc values used for screening QT prolongation in school cardiac screening are generated by manual measurements; when such values are used in automatic measurements, overscreening occurs.

Methods: We retrospectively analyzed the electrocardiogram records of all first- and seventh-grade students who underwent school cardiac examinations in Kagoshima City from 2009 to 2013. Only students screened using the automated QTc values underwent manual measurements, and those who exceeded the manual reference QTc values were selected. The automated reference values were developed according to the automatically measured QTc values of the extracted students.

Results: Out of 54,586 students, 1233 (2.3%) were screened using manual measurement. Among them, 52 (0.10%) exceeded the reference QTc values. The lowest automated QTc values were 445 and 447 ms for first-, 463 and 451 ms for seventh-grade male and female students, respectively.

Conclusion: The reference values for the automatic screening of QT prolongation were 445 and 450 ms in first- and seventh-grade students, respectively.

Key words: screening; long QT syndrome; automatic analysis; school heart examination

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This page was last modified on 2021-04-15T08:42:05.000+09:00


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