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目的通过分析62例扩张型心肌病(DCM)患者的临床资料,探讨心腔扩大与恶性室性律失常之间的关系。方法选取DCM患者62例,采用心脏多普勒超声检查左心房内径(LAD)和左心室舒张末期内径(LVEDd),根据LVEDd分为三组:50～59mm组,60～69mm组,≥70mm组;根据LAD分为两组:<35mmn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及24小时动态心电图记录心电资料。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 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;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 Sixty-two patients with DCM were selected. Left atrium diameter (LAD) and left ventricular end-diastolic diameter (LVEDd) were examined by Doppler echocardiography. According to LVEDd, they were divided into three groups: 50 ~ 59mm group, 60 ~ 69mm group, ; According to the LAD divided into two groups: <35mmn group, ≥ 35mm group; According to the NYHA standard, all patients were divided into two groups: 1,2 for the group; 3,4 for the group Ⅱ; conventional 12-lead ECG And 24-hour Holter ECG data. Results The incidence of malignant arrhythmia in 60 ~ 69mm group and ≥70mm group was significantly higher than that in 50 ~ 59mm group according to LVEDd (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). Conclusion DCM patients with increased left ventricular mass significantly increased the incidence of malignant ventricular arrhythmias; higher incidence of malignant arrhythmia; with left atrial enlargement, the incidence of atrial fibrillation increased.