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目的探讨扩张型心肌病(DCM)的心脏结构、心律失常与预后的关系。方法将43例DCM患者分为存活组(33例)与死亡组(10例),回顾分析其超声心动图、心电图(ECG)、24小时动态心电图(Holter)等资料,比较两组的临床特点。结果与存活组对比,死亡组的左房内径(LAD)、左室舒张末内径(LVEDd)扩大(P<0·05),左心室射血分数(LVEF)、左心室短轴缩短分数(LVFS)降低(P<0·01);严重室性心律失常(Lown氏Ⅲ级以上室性心律失常)的发生率明显升高(P<0·005);NYHA标准心功能Ⅳ级患病率高(P<0·01);QT离散度(QTd)及校正QT离散度(QTcd)明显延长(P<0·01)。结论DCM的左房左室明显扩大、左心功能严重损害、严重室性心律失常的发生率增高以及QTd、QTcd明显延长是DCM患者死亡的高危因素。
Objective To investigate the relationship between cardiac structure, arrhythmia and prognosis in dilated cardiomyopathy (DCM). Methods 43 patients with DCM were divided into survival group (n = 33) and death group (n = 10). Echocardiography, electrocardiogram (ECG) and Holter were retrospectively analyzed. The clinical features . Results Compared with the survival group, left atrium diameter (LAD), left ventricular end diastolic diameter (LVEDd), left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS) ) (P <0.01); the incidence of severe ventricular arrhythmia (Lown’s Ⅲ above ventricular arrhythmia) was significantly increased (P <0 · 005); NYHA standard heart function grade Ⅳ high prevalence (P <0.01); QT dispersion and QT dispersion (QTcd) were significantly prolonged (P <0.01). Conclusion DCM left ventricular left ventricular enlargement, severe left ventricular dysfunction, increased incidence of severe ventricular arrhythmias and QTd, QTcd significantly prolonged risk of death in DCM patients.