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目的分析扩张型心肌病(DCM)患者心律失常的发生及与心功能的关系。方法DCM患者87例,通过同步12导联心电图和24-h动态心电图判断心律失常的发生,结合心脏超声、胸部X射线、血浆脑利钠肽(BNP)测定和心功能评级分析心律失常的发生及与心功能的关系。结果87例中,有3种或3种以上心律失常69例(79.31%),严重心律失常70例(80.46%)。心功能Ⅲ和Ⅳ级患者的严重心律失常发生率分别为89.74%和90.91%,高于心功能Ⅱ级患者的33.33%(P<0.05)。左心房内径≥45 mm患者的心房颤动发生率高于左心房内径<45 mm患者(P<0.05)。左心室射血分数(LVEF)≤35%和左心室舒张末内径(LVEDD)≥60mm患者的严重心律失常发生率高于LVEF>35%、LVEDD<60mm患者(P<0.05)。结论 DCM患者心律失常发生率高,并且多发严重心律失常,与心功能状况不佳一致。DCM患者房性和室性心律失常的发生分别与心房和心室的构型改变相关。
Objective To analyze the relationship between arrhythmia and cardiac function in patients with dilated cardiomyopathy (DCM). Methods Eighty-seven patients with DCM were enrolled in this study. Cardiac arrhythmia was determined by synchronous 12-lead electrocardiogram (ECG) and 24-h Holter monitoring. Cardiac arrhythmia was assessed by echocardiography, chest X-ray, plasma BNP and cardiac function And the relationship between heart function. Results Among 87 cases, 69 cases (79.31%) had three or more arrhythmias and 70 cases (80.46%) had severe arrhythmia. The incidence of serious arrhythmia in patients with grade Ⅲ and Ⅳ cardiac function was 89.74% and 90.91%, respectively, which was higher than 33.33% (P <0.05) in patients with grade Ⅱ cardiac function. The incidence of atrial fibrillation in patients with atrial diameter ≥45 mm was higher than that in patients with atrial diameter <45 mm (P <0.05). The incidence of severe arrhythmia in patients with LVVED ≤35% and LVEDD ≥60 mm was significantly higher than those with LVEF> 35% and LVEDD <60 mm (P <0.05). Conclusion DCM patients with high incidence of arrhythmia, and multiple serious arrhythmia, consistent with poor cardiac function. The occurrence of atrial and ventricular arrhythmias in patients with DCM is associated with changes in the configuration of the atria and ventricles, respectively.