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目的通过分析62例扩张型心肌病(Dilated Cardiomyopathy,DCM)患者的临床资料,探讨心腔扩大与恶性室性心律失常之间的关系。方法选取DCM患者62例,采用心脏多普勒超声检查左房内径(Left atrial diameter,LAD)和左室舒张末期内径(Left ventricular end diameter diastolic,LVEDd),根据LVEDd分为三组(50~59mm组,60~69mm组,≥70mm组)、根据LAD分为两组(<35mm组,≥35mm组)、根据NYHA标准,将所有患者分为两组(1、2级为Ⅰ组;3、4级为Ⅱ组);常规十二导连心电图(Electrocardiogram,ECG)及24小时动态心电图(Dynamic Electrocardiogram,DCG)记录心电资料。结果根据LVEDd所划分的60~69mm组和≥70mm组恶性心律失常的发生率明显比50-59mm组高(P<0.01);根据LAD所划分的≥35mm组的心房颤动的发生率明显比<35mm组增高(P<0.01);根据心功能所划分的Ⅱ组的恶性心律失常的发生率明显比Ⅰ组增多(P<0.01)。结论本研究表明,DCM患者随着左心室的明显增大,恶性室性心律失常发生率增高;心衰程度重,恶性心律失常发生率更高;伴左心房扩大者,房颤的发生率增高。
Objective To investigate the relationship between cardiac enlargement and malignant ventricular arrhythmias by analyzing the clinical data of 62 patients with dilated cardiomyopathy (DCM). Methods Totally 62 patients with DCM were selected. Left atrial diameter (LAD) and left ventricular end diastolic diameter (LVEDd) were measured by Doppler echocardiography, and divided into three groups (50 ~ 59mm The patients were divided into two groups according to NYHA criteria (group 1, group 2, group I, Group 4 was group Ⅱ). Electrocardiogram (ECG) and 24-hour dynamic electrocardiogram (DCG) were recorded routinely. Results According to LVEDd, the incidence of malignant arrhythmia in 60 ~ 69mm group and ≥70mm group was significantly higher than that in 50-59mm group (P <0.01). The incidence of atrial fibrillation in ≥35mm group according to LAD was significantly lower than < 35mm group (P <0.01). The incidence of malignant arrhythmia in group Ⅱ was significantly higher than that in group Ⅰ (P <0.01). Conclusions This study shows that DCM patients with increased left ventricular significantly increased the incidence of malignant ventricular arrhythmias; severe heart failure, a higher incidence of malignant arrhythmias; with atrial enlargement, the incidence of atrial fibrillation increased .