心肌病患者心功能改变与心律失常发生率的关系研究  

The relationship between cardiac function change and arrhythmia ratio in patients with cardiomyopathy

作　　者：周清芬[1] 任妍[2] 张凤如[2] 李慧[3] 

机构地区：[1]上海交通大学医学院附属瑞金医院心脏科,200025 [2]上海交通大学医学院附属瑞金医院老年科,200025 [3]上海交通大学医学院附属瑞金医院卢湾分院心内科,200020

出　　处：《国际心血管病杂志》2017年第6期381-383,共3页International Journal of Cardiovascular Disease

摘　　要：目的:探讨心肌病患者心功能变化与心律失常发生率的关系。方法:入选849例心肌病患者,其中扩张型心肌病472例,缺血性心肌病377例。检测患者N末端脑钠肽前体(NT-proBNP)水平,并对患者行超声心动图、心电图检查。根据左室射血分数(LVEF)结果,患者分为LVEF≥40%组、30%≤LVEF<40%组及LVEF<30%组;根据NT-proBNP结果,患者分为NT-proBNP≥500 pg/mL组和NT-proBNP<500 pg/mL组。分别记录各组心电图的心律失常、主动性异位心律失常、传导阻滞的发生率。结果:与LVEF≥40%组相比,30%≤LVEF<40%组和LVEF<30%组心肌病患者的心律失常、主动性异位心律失常、传导阻滞的发生率均明显升高(P均<0.05);与30%≤LVEF<40%组相比,LVEF<30%组心肌病患者心律失常、主动性异位心律失常、传导阻滞的发生率均明显升高(P均<0.05)。与NT-proBNP<500 pg/mL组相比,NT-proBNP≥500 pg/mL组的心律失常、主动性异位心律失常、传导阻滞发生率均明显升高(P均<0.05)。结论:心肌病患者的心功能越差,心律失常发生率越高。心电图可帮助筛查心律失常事件,间接了解心肌病患者的心功能情况。Objective： To explore the relationship between cardiac function change and arrhythmia ratio in the cardiomyopathy patients. Methods： A total of 849 cardiomyopathy patients were enrolled with 472 cases of dilated cardiomyopathy （DCM） and 377 cases of ischemic cardiomyopathy （ICM）. The level of NT-proBNP was measured, and the echocardiography and electrocardiogram （ECG） were performed. According to the LVEF results, patients were divided into LVEF≥40% group, 30≤ LVEF〈40% group and LVEF〈30% group. According to the levels of NT-proBNP, patients were divided into NT-proBNP≥500 pg/mL group and NT-proBNP〈500 pg/mL group. The incidence of arrhythmia, active eetopic arrhythmia and conduction block were recorded among each group. Results： Compared with the LVEF≥40% group, the incidences of arrhythmia, active ectopic arrhythmia and conduction block were significantly increased in the other two groups （all P〈0. 05）. Compared with the 30≤LVEF（40% group, the incidences of the arrhythmias mentioned above were significantly higher in the LVEF〈30% group （all P〈0. 05）. Compared with the NT-proBNP〈500 pg/mL group, the incidences of the arrhythmias were significantly higher in the NT-proBNP〉/500 pg/mL group （all P〈0. 05）. Conelusions：The incidence of arrhythmia is higher in the cardiomyopathy patients with worse cardiac function. ECG can be used to screen arrhythmia events and indirectly understand the cardiac function of patients with cardiomyopathy.

关 键 词：心肌病 心电图 心律失常 

分 类 号：R541.7[医药卫生—心血管疾病] R542.2[医药卫生—内科学]