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目的探讨完全性左束支传导阻滞(CLBBB)对扩张型心肌病患者的心功能的影响。方法选择52例扩张型心肌病住院患者,将其分为合并完全性左束支传导阻滞组21例、正常窦性心律组31例,所有患者进行超声心动图检查,并对心脏结构和功能进行比较。结果与正常窦性心律组相比,CLBBB组患者年龄、左室收缩末内径(LVESD)、左室舒张末内径(LVEDD)均大于正常窦律组(P<0.01);CLBBB组患者室间隔厚度(IVSd)、左室射血分数(LVEF)均小于正常窦律组(P<0.05,P<0.05)。年龄、LVESD及LVEDD分别与CLBBB呈正相关(r=0.541,P=0.000;r=0.398,P=0.012;r=0.404,P=0.009);IVSd与CLBBB呈显著负相关(r=-0.354,P=0.019);LVEF与CLBBB无相关性(r=-0.288,P=0.061)。二分类Logistic回归分析结果显示年龄和LVEDD为CLBBB发生的预测因素(P=0.027,OR=1.196,95%CI:1.020~1.402;P=0.018,OR=1.224,95%CI:1.035~1.447)。结论完全性左束支传导阻滞会加重扩张型心肌病患者左心室功能的损害,年龄和左室舒张末内径可能为扩张型心肌病患者CLBBB发生的危险因素。
Objective To investigate the effect of complete left bundle branch block (CLBBB) on cardiac function in patients with dilated cardiomyopathy. Methods Fifty-two hospitalized patients with dilated cardiomyopathy were divided into 21 cases with complete left bundle branch block and 31 cases with normal sinus rhythm. All patients underwent echocardiography and their cardiac structure and function Compare. Results Compared with normal sinus rhythm group, age, left ventricular end-systolic diameter (LVESD) and left ventricular end diastolic diameter (LVEDD) in CLBBB group were significantly higher than those in normal sinus rhythm group (P <0.01) (IVSd) and left ventricular ejection fraction (LVEF) were lower than those in normal sinus rhythm group (P <0.05, P <0.05). Age, LVESD and LVEDD were positively correlated with CLBBB (r = 0.541, P = 0.000; r = 0.398, P = 0.012; r = 0.404, P = 0.009) = 0.019). There was no correlation between LVEF and CLBBB (r = -0.288, P = 0.061). Logistic regression analysis showed that age and LVEDD were predictors of CLBBB (P = 0.027, OR = 1.196, 95% CI: 1.020-1.402; P = 0.018, OR = 1.224, 95% CI: 1.035-1.457). Conclusion Complete left bundle branch block may aggravate left ventricular dysfunction in patients with dilated cardiomyopathy. Age and left ventricular end-diastolic diameter may be risk factors for CLBBB in patients with dilated cardiomyopathy.