心动过速性心肌病的临床特点和诊治  

Clinical Characteristics,Diagnosis and Treatment of Tachycardiomyopathy

作　　者：马坚[1,2] 王方正[1,2] 张云[1,2] 唐晓毅 孙瑞龙 陈新[1,2] 

机构地区：[1]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院临床电生理研究室 [2]北京邮电职工总医院心内科

出　　处：《中国循环杂志》1997年第5期367-369,共3页Chinese Circulation Journal

摘　　要：目的：观察心动过速性心肌病的临床表现和诊治过程。方法：５例慢性房性心动过速伴心脏扩大和心力衰竭患者服用胺碘酮治疗，对比治疗前后的心率、心脏大小和心功能变化。结果：胺碘酮治疗后，５例患者转复为窦性心律，平均心室率由１６６．０±１８．０降至８０．４±９．６次／分（Ｐ＜０．０１），左心室舒张末径和心胸比率均显著性减少（６３．７０±７．１０比５２．５０±６．１０ｍｍ，和０．５６±０．０５比０．５０±０．０３，Ｐ＜０．０５），左心室射血分数则提高１０１％（Ｐ＜０．０１），随访２年，患者的心脏功能进一步改善。结论：慢性心动过速可成为心脏扩大和心功能不全的原发病因，控制心室率后心脏功能可完全恢复正常。Objective:To observe the clinical characteristics,diagnosis and treatment of tachycardiomyopathy. Methods:Five patients with chronic atrial tachycardia and heart failure were treated with amiodarone,the heart rate,heart size and cardiac function were compared before and after treatment. Results:After treatment with amiodorone,sinus rhythm was recovered in five patients,mean heart rate was dropped from 166 0±18 0 to 80 4±9 6 bpm( p <0.01),left ventricular end diastolic diameter and cardiothoracic ratio were significantly reduced(63.70±7.10 vs.52.50±6.10 mm and 0.56±0.05 vs.0.50± 0.03 ,respectively, p <0.05),while left ventricular ejection fraction was obviously increase(101%, p <0.01).During follow up of two years,cardiac function was further improved. Conclusion:This study suggests that the chronic uncontrolled tachycardia may become a primary cause of heart dilatation and heart failure,which is reversible after control of heart rate.

关 键 词：心动过速 心肌病 心力衰竭 心率 诊断 治疗 

分 类 号：R541.71[医药卫生—心血管疾病] R542.2[医药卫生—内科学]