儿童特发性室性早搏负荷量与心功能的关系  

作　　者：何跃娥[1] 姜剑斌[1] 仇慧仙[1] 张园海[1] 吴蓉洲[1] 项如莲[1] 

机构地区：[1]温州医科大学附属第二医院儿童心脏中心,325000

出　　处：《浙江临床医学》2016年第2期250-252,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨儿童特发性室性早搏（IPVCs）不同负荷对患儿左心功能的影响。方法入选186例IPVCs患儿，根据24h动态心电图室性早博（简称室早）早数量与24h总心搏的比值，将入选患儿分为三组：低负荷组（室早负荷〈10％），中等负荷组（10％~20％）和高负荷组（〉20％）。采用二维超声心动图分别测量患儿左心室射血分数（LVEF），左心室舒张末期内径（LVDd），左心室收缩末期内径（LVDs）值，计算左心室舒张末期容积指数（EDVI），并检测患儿血浆氨基末端脑钠肽（NT-proBNP）水平。结果与中低负荷组比较，高负荷组EDVI水平显著升高（P〈0．05），而LVEF值明显降低（P均〈0．01），三组之间血浆NT-proBNP水平差异有显著性（P〈0．01）。室早负荷与EDVI、血清NT-proBNP水平呈正相关（r=0．487、0．573，P〈O．05），和LVEF呈负相关（r=-0．553，P〈0．01）。结论儿童IPVCs负荷与左心功能密切相关，高负荷可能导致患儿心功能的下降。Objective The purpose of this study was to observe the relationship between the burden of idiopathic premature ventricular contractions （ IPVCs ） and ventricular function in children.Methods A total 186 patients with IPVCs who had no underlying heart disease were observed.These patients were divided into three subgroups according to the burden of PVCs： the lower burden group （ 〈10% ） , the middle burden group （ 10%to 20% ） , and the higher burden group （ 〉20% ） .The burden of PVCs was determined by 24-hour Holter monitoring. Left ventricular ejection fraction （ LVEF ） , left ventricular end-diastolic diameter （ LVDd ） and left ventricular end-systolic diameter （ LVDs ） were measured by transthoracic echocardiograph, and then left end diastolic volume index （ EDVI ） was calculated.Plasma NT-proBNP level was tested by using the rapid quantitative detection card. The parameters of left cardiac structure and function in each subgroup were analyzed with statistical methods.Results Compared with the lower and the middle burden group, EDVI levels in the higher burden group were significantly increased （ P=0.03;0.018 ） , while LVEF were decreased （ P〈0.01 ） . There were significant differences in NT-proBNP between the three groups （ P〈0.01 ） . There was positive correlation between the burden of PVC and EDVI. the NT-proBNP level （r=0.487. 0.573 P〈0.01 ） , and negative correlation between the burden of PVCs and LVEF （ r=-0.553 P〈0.01 ） .Conclusions IPVCs burden in children was closely associated with left ventricular function, high burden may lead to left ventricular decreaded in children.

关 键 词：特发性室性早搏 心室功能 氨基末端脑钠肽 儿童 

分 类 号：R654.2[医药卫生—外科学]