中青年扩张型心肌病伴心力衰竭患者心功能的临床研究

目的探讨青年人扩张型心肌病伴或不伴心力衰竭与心脏功能关系及临床意义。方法对我院扩张型心肌病伴有心力衰竭患者65例（心力衰竭组）和不伴有心力衰竭患者58例（非心力衰竭组）给予超声心动图、心电图检查。比较两组心脏的大小、功能以及发生心律失常的情况。结果①心力衰竭组的左心室收缩末内径（LVESd）、左心室舒张末内径（LVEDd）、左心房内径（LAD）、左心室射血分数（LVEF）,左心室短轴缩短分数（LVFS）与非心力衰竭组比较,差异有统计学意义（P〈0.01）。②心力衰竭组在心电图上的QRS时限、肢导低电压、异常Q波、ST-T改变的比例略高于非心力衰竭组,差异无统计学意义（P〉0.05）。心力衰竭组的房性心律失常、室性心律失常和传导阻滞发生率与非心力衰竭组比较,差异有统计学意义（P〈0.01）。③心力衰竭组患者入院时心脏功能Ⅲ级、Ⅳ级分别占58.4%、21.5%。两组经住院治疗后,心脏功能较入院时明显改善（P〈0.05）。结论扩张型心肌病伴心力衰竭、心律失常时,LVEDd明显增大,LVEF显著降低,并与心脏功能有一定的相关性。早期诊断和治疗,除去心力衰竭诱发因素,能够改善心脏功能,提高患者的生活质量,改善预后。

Cardiac function of young and middle-aged patients with dilated cardiomyopathy complica-ting heart failure

Objective To explore the relationship between cardiac function and dilated cardio-myopathy with or without heart failure among young and middle-aged patients and discuss its clinical significance.Methods Examinations of echocardiogram and ECG were carried out on 123 patients with dilated cardiomyopathy in our hospital,among whom were 65 cases complicating heart failure （heart-failure group）and 58 cases not accompanied with the disease（non-heart-failure group）.Be-tween the 2 groups,the sizes of heart,cardiac function and the occurrence of arrhythmia were com-pared.Results Compared with non-heart-failure group,the differences in left ventricular end sys-tolic diameter （LVESd ）,left ventricular end diastolic diameter （LVEDd ）,left atrial diameter （LAD）,left ventricular ejection fraction（LVEF）and left ventricular fractional shortening（LVFS） of heart-failure group were statistically significant（P〈0.01）.②The incidences of changes of QRS duration,low voltage in limb leads,abnormal Q waves and ST-T segment in heart-failure group were all slightly higher than those of non-heart-failure group,without statistically significant differences （P〉0.05）.Compared with non-heart-failure group,there were statistically significant differences＆amp;nbsp;（P〈0.01 ）in the incidences of atrial arrhythmia,ventricular arrhythmia and conduction block in heart-failure group.③ On admission,cardiac function of patients in heart-failure group was classi-fied into level Ⅲ and Ⅳ,accounting for 58.4%and 21.5%,respectively.After treatment in hos-pital,cardiac function of the 2 groups both improved significantly compared with that on admission （P〈0.05）.Conclusion Dilated cardiomyopathy is followed by obvious increase of left ventricular end diastolic diameter and significant decrease of left ventricular ejection fraction（LVEF）if accompanied with heart failure and arrhythmia while the phenomena are more or less associated with cardiac func-tion.By getting rid of inducing factors of heart