心动过速心肌病的临床特点及与扩张性心肌病的对照分析

目的 探讨心动过速心肌病（TCM）的诊断线索.方法 选取我院2010年1月～2013年1月诊断为TCM的患者6例,随机1∶3匹配年龄（±5岁）和射血分数相近、同性别、同年出院诊断为扩张性心肌病（DCM）的患者18例,分析两类心肌病的临床特点和治疗结果.结果 与TCM组相比,DCM组急性期入院时心率较低,两组分别为（99.4±10.5）次/分和（146±20.4）次/分（P＜0.05）,在心衰缓解时心力率竭显著降低,两组分别为（74.9±8.8）次/分和（122.5±24.9）次/分（P＜0.05）.TCM组术后3个月心脏显著缩小、左室射血分数显著上升（P＜0.05）,而DCM组出院后3个月无明显变化.结论 与DCM相比,TCM的心力率竭在心衰急性期、缓解期显著加快,即使在缓解期也常＞90次/分.故对心肌病患者,须注意鉴别并积极治疗心动过速.

The clinical characteristics of tachycardia-induced cardiomyopathy and the comparative analysis with dilated cardiomyopathy

Objective To study the clinical characteristics of tachycardia-induced cardiomyopa- thy （TCM）. Methods Six patients with TCM and 18 matched-control patients with idiopathic dilated car- diomyopathy（DCM） were assessed retrospectively. The clinical courses and outcomes after treatment,heart rate in acute and chronic phase, and echocardiography parameters of the two kinds of patients were ana- lyzed. Results The heart rate in acute phase and chronic phase of patients with DCM was significantly lower than that of patients with TCM （ acute phase ： 99.4 ＋ 10.5 vs. 146.0 ＋ 20.4 beats per minute, P 〈 0.05, chronic phase 74.9 ＋ 8.8 vs. 122.5 ＋ 24.9 beats per minute, P 〈 0.05 ）. The cardiac size and left veutricular ejection fraction of patients with TCM had remarkable changes during follow up at three month after success procedures ,whereas those parameters of patients with DCM had no dramatically changes dur- ing follow up at three month after discharge. Conclusions The heart rate in acute phase and chronic phase of patients with DCM was significantly lower than that of patients with TCM. The heart rate of pa- tients with TCM was always greater than 90 beats per minute, even in chronic phase without obvious symp- toms.