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探讨影响小儿扩张型心肌病（ＤＣＭ）预后的有关因素，以期提高疗效。总结了１９８４年至１９９４年间６４例小儿ＤＣＭ长期随访结果，分析发病年龄、心功能、心律失常、不同治疗等对生存率的影响。结果心律失常组（ｎ＝２１）１年及５年生存率分别为７５％、５１％，低于无心律失常组（分别为９７％、８３％，Ｐ＜０．０５）。年龄、ＦＳ、卡托普利或激素使用与否对生存率未见显著影响。但激素组ＦＳ值显著低于非激素组（Ｐ＜０．０１）。１８例存活≥５年者与同期收治的其余病例（ｎ＝３８）相比，年龄较小，卡托普利使用率较高（Ｐ值均＜０．０５）；其ＦＳ值除１例缺失外，全部恢复正常或明显改善。Ｃｏｘ风险度回归分析示，心律失常为影响生存的主要指标（Ｐ＜０．０５）。结论：心律失常为小儿ＤＣＭ预后不良的重要指标；ＦＳ的动态改变有助于判断预后
To explore the factors affecting the prognosis of children with dilated cardiomyopathy (DCM) in order to improve the curative effect. Long-term follow-up of 64 pediatric patients from 1984 to 1994 was summarized, and the influence of age of onset, cardiac function, cardiac arrhythmia and different treatment on survival rate was analyzed. Results The 1- and 5-year survival rates of the arrhythmia group (n = 21) were 75% and 51%, respectively, lower than those without arrhythmia (97% and 83%, respectively; P <0.05). Age, FS, captopril, or hormone use had no significant effect on survival. However, FS value in hormone group was significantly lower than that in non-hormone group (P <0.01). Eighteen patients who survived for more than 5 years had a younger age and a higher rate of use of captopril (P <0.05) than those in the remaining patients (n = 38) Outside, all returned to normal or significantly improved. Cox risk regression analysis showed that arrhythmia was the main indicator of survival (P <0.05). Conclusion: Arrhythmia is an important indicator of poor prognosis in children with DCM. The dynamic changes of FS contribute to the prognosis