46例心肌致密化不全患者心律失常特征及其与受累部位关系  

The analysis for arrhythmia characterics in patients with noncompaction of ventricular myocardium

作　　者：蒋桔泉[1] 丁世芳[1] 陈志楠[1] 夏利[2] 向慧娟[2] 卢青[1] 龚志刚[1] 李志刚[1] 

机构地区：[1]广州军区武汉总医院心血管内科,湖北武汉430070 [2]广州军区武汉总医院超声影像科,湖北武汉430070

出　　处：《中国心脏起搏与心电生理杂志》2014年第5期412-414,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的探讨心肌致密化不全(NVM)心肌病患者的心律失常特征及其与致密化不全部位关系。方法经二维彩色多普勒超声心动图诊断NVM 46例,行12导联动态心电图检查,分析其心律失常特征及其与致密化不全受累范围与部位关系。结果快速性心律失常者26例,其中16例患者同时发生两者以上心律失常;缓慢性心律失常者11例,3例有2种以上心律失常;轻微心律失常9例。快速心律失常中以频发室性早搏最多,其次为心房颤动,缓慢性心律失常以窦性心动过缓最多,其次为心房扑动伴缓慢心室率和高度或Ⅲ度房室传导阻滞。与轻微心律失常组相比,缓慢性心律失常和快速心律失常组受累范围更大,心律失常类型与受累部位尚无明确关系。根据发病年龄,小于45岁患者23例,有7例发生缓慢性心律失常,大于45岁者23例,3例发生缓慢性心律失常,两组相比,差异有显著性(P<0.05)。结论 NVM患者心律失常发病率高,快速心律失常发生率高于缓慢性心律失常,致密化不全受累范围越大,心律失常发生率越高;小于45岁年龄组与大于45岁年龄组相比,缓慢性心律失常发生率较高。Objective To analyze the arrhythmia characterics in patients with noncompaction of ventricular myocardium （NVM） , to find the relationship between arrhythmia eharaeteries and position of NVM. Methods The study comprised 46 patients with NVM evaluated by echocardiography in our hospital from June 2003 to June 2013. Dynamic electrocardiogram was used to detect arrhythmias and arrhythmia characterics was described. The relationship between arrhythmia characterics and position of NVM was analyzed. Results Forty-six cases of patients diagnosed from 9 to 78 years old, mean （46.6 ± 19.7） years old, male 27 cases, female 19 cases. There were taehyarrhythmia in 26 cases, bradyarrhythmia in 11 cases, mild arrhythmia in 9 cases. Sixteen patients of tachyarrhythmia with more than two arrhythmias, 3 patients of brady- arrhythmia with more than two arrhythmias; Tachyarrhythmia includes frequent premature ventricular beats（ 37.0% ） , atrial fibrillation （ 10.9% ）. Bradyarrhythmia includes sinus bradycardia （ 10.9% ） , atrial flutter with slow ventricular rate （6. 5% ） , height or third degree atrioventricular block（4.2% ）. The area of NVM was bigger in tardy arrhythmia group and rapid arrhythmia group than in mild arrhythmia group. There were 7 cases of bradyarrhythmia in 23 cases of young than 45 years, but only 3 cases of bradyarrhythmia in 23 cases of older than 45 years, there was significant difference between two groups（ P〈0.05 ）. Conclusions Arrhythmia is common presentations in patients with NVM , with the characteristics of high incidence, diversity and complexity. The incidence of tachyarrhythmia was significantly higher than that of bradyarrhythmia. The incidence of bradyarrhythmia was significantly higher in young patients than older patients.

关 键 词：心血管病学 心肌致密化不全 心律失常 动态心电图 致密化不全部位 

分 类 号：R541.7[医药卫生—心血管疾病] R540.41[医药卫生—内科学]