扩张型心肌病患儿左心室射血分数变化及危险因素分析  

Changes of Left Ventricular Ejection Fraction in Patients with Dilated Cardiomyopathy and the Related Risk Factors

作　　者：蔡海明[1] 郑燕红[2] 蓝雅琼[3] 林惠泉[1] 

机构地区：[1]福建医科大学附属漳州市医院儿科,福建漳州363000 [2]解放军第一七五医院厦门大学附属东南医院药学科,福建漳州363000 [3]福建医科大学附属漳州市医院总务科,福建漳州363000

出　　处：《医学综述》2016年第24期4927-4930,共4页Medical Recapitulate

摘　　要：目的 观察扩张型心肌病患儿左心室射血分数（LVEF）变化,分析其危险因素。方法 选取2013年1月至2015年6月福建医科大学附属漳州市医院儿科诊治的扩张型心肌病患儿84例为观察组,另选择40例健康儿童为对照组。所有患儿均于入院后3 d内行心脏超声检查及实验室检查。比较不同心功能分级患儿LVEF差异,对影响患儿LVEF的相关因素进行分析,内容包括性别、年龄、左心房内径（LAD）、左心室内径（LVDD）、右心房内径（RAD）、右心室内径（RVD）、室间隔厚度（IVSD）、左心室壁厚度（LVPWD）、肌酸激酶同工酶（CK-MB）及脑钠肽（BNP）及心功能。结果 观察组患儿LVEF显著低于对照组[（30.4±3.6）%比（62.3±14.3）%],差异有统计学意义（P〈0.05）。LVEF〈50%的患儿52例,LVEF≥50%的患儿32例,单因素分析显示,IVSD（〉10.2 mm）、LVPWD（〉10.1 mm）及CK-MB（〉22.3 U/L）及心功能分级（Ⅲ、Ⅳ级）比例显著高于IVSD（≤10.2 mm）、LVPWD（≤10.1 mm）、CK-MB（≤22.3 U/L）及心功能分级（Ⅰ~Ⅱ级）,差异有统计学意义（P〈0.05）。经Logistic多因素分析,IVSD（〉10.2 mm）（OR=1.674,95%CI 1.045~2.682）、LVPWD（〉10.1 mm）（OR=1.421,95%CI 1.175~1.719）及心功能分级（Ⅲ、Ⅳ级）（OR=2.142,95%CI0.024~4.510）是影响扩张型心肌病患儿LVEF的危险因素。结论 扩张型心肌病患儿LVEF存在不同程度降低,IVSD、LVPWD及心功能分级是影响扩张型心肌病患儿LVEF降低的重要危险因素。Objective To observe the changes of left ventricular ejection fraction in patients with dilated cardiomyopathy,and analyze its risk factors. Methods From Jan. 2013 to Jun. 2015, 84 cases of dilated cardiomyopathy in Zhangzhou Hospital Affihated to Fujian Medical University were included in the study, and another 40 healthy children were included as a control group. All of the children received heart ultrasound examination and laboratory examination 3 d after admission. The LVEF of patients with different cardiac function classification was compared, and the related factors affecting LVEF in children were analyzed, including gender, age, left atrial diameter（ LAD）, left ventricular diameter （ LVDD ）, right atrial diameter （ RAD ）, right ventricular diameter （ RVD ）, left ventricular wall thickness （ LVPWD）, ventricular septal thickness （ IVSD ）, creatine kinase isoenzyme （CK-MB）, brain uatriuretic peptide （BNP） and cardiac function. Results The LVEF of the observation group was significantly lower than the control group [ （30. 4 ±3.6 ）% vs （62. 3 ± 14. 3 ） % ] ,the difference was statistically significant（P 〈0. 05）. LVEF 〈50% patients had 52 cases, LVEF≥ 50% patients had 32 cases. Single factor analysis showed that the LVEF proportions of IVSD（ 〉 10. 2 mm）, LVPWD（ 〉 10. 1 mm） and CK-MB（ 〉22.3 U/L） and cardiac function classification（ Ⅲ, Ⅳ） were significantly higher than that of IVSD（ ≤10. 2 mm） ,LVPWD（ ≤10. 1 mm） CK-MB（ ≤22. 3 U/L） and cardiac function classification（ Ⅰ -Ⅱ ）, and the differences were statistically significant （P 〈0. 05 ）. Logistic multi- variate analysis showed that IVSD （ 〉 10. 2 mm） （ OR = 1. 674,95% CI 1. 045-2. 682 ）, LVPWD （ 〉 10. 1 mm） （ OR = 1. 421,95 % CI 1. 175-1.719 ） and cardiac function classification （ grade Ⅲ, Ⅳ ） （ OR = 2. 142,95% CI 0. 024-4. 510） were risk factors affecting LVEF in patients with dilated cardiomyopathy. Conclusion The LVEF in

关 键 词：扩张型心肌病 心力衰竭 左心室射血分数 

分 类 号：R725.4[医药卫生—儿科]