【摘要】：目的探討擴張型心肌病(dilated cardiomyopathy,DCM)患者心率減速力(heart rate deceleration capacity,DC)的變化及其對DCM患者生存率的影響。方法選擇在我院住院的69例DCM患者(DCM組)和165例非器質(zhì)性心臟病患者(對照組),行心臟超聲和24小時動態(tài)心電圖檢查,應(yīng)用相應(yīng)軟件對動態(tài)心電圖進行分析并記錄DC值和心率加速力(heart rate acceleration capacity,AC)值,比較兩組間DC值和AC值的差別。對DCM患者進行隨訪,共隨訪60個月,觀察終點事件為心源性死亡(cardiac death,CD),根據(jù)其有無CD分為高風(fēng)險組(19例)及低風(fēng)險組(50例),采用Cox回歸分析和Kaplan-Meier生存分析DC值對DCM患者生存率的影響。結(jié)果1)與對照組相比,DCM患者DC值、AC絕對值均降低(4.0±1.82 vs 7.2±0.53,-4.5±1.91 vs-7.9±1.14,P0.01),DCM患者DC值與左房內(nèi)徑呈負相關(guān)(r=-0.278,P0.05);2)與低風(fēng)險組相比,DCM高風(fēng)險組患者DC值和AC絕對值明顯降低(2.8±1.03vs 4.4±1.94,-3.5±1.16vs-4.9±2.09,P0.05);DCM患者DC值降低是CD的危險因素之一;3)與DC≥4.5ms者相比,DCM組DC值4.5ms者生存率明顯降低(log-rank=4.837,P0.05)。結(jié)論擴張型心肌病患者心率減速力降低提示自主神經(jīng)功能受損,是發(fā)生心源性死亡的危險因素之一,心率減速力小于4.5ms者生存率下降。
[Abstract]:Objective to investigate the changes of heart rate deceleration force (heart rate deceleration capacity,DC) in patients with dilated cardiomyopathy (dilated cardiomyopathy,DCM) and its effect on survival rate of DCM patients. Methods Sixty-nine patients with DCM (DCM group) and 165 patients with non-organic heart disease (control group) in our hospital were examined by echocardiography and 24 hours ambulatory electrocardiogram. The dynamic electrocardiogram (ECG) was analyzed by using the corresponding software and the DC value and the (heart rate acceleration capacity,AC value of heart rate acceleration were recorded. The difference of DC value and AC value between the two groups was compared. The patients with DCM were followed up for 60 months. Cardiac death (cardiac death,CD) was observed and divided into high risk group (19 cases) and low risk group (50 cases) according to their CD. Cox regression analysis and Kaplan-Meier survival analysis were used to analyze the effect of DC value on the survival rate of DCM patients. Results 1) compared with the control group, the DC value and the absolute AC value of DCM patients were significantly lower (4.0 鹵1.82 vs 7.2 鹵0.53 鹵4.5 鹵1.91 vs-7.9 鹵1.14 P 0.01, respectively) and the DC values were negatively correlated with the left atrial diameter (r = 0.278 P 0.05), 2) compared with the low risk group, the DC value and AC absolute value of DCM high risk group were significantly lower (2.8 鹵1.03vs 4.4 鹵1.94 鹵3.5 鹵1.16vs-4.9 鹵2.09 Reduction was one of the risk factors for CD. 3) compared with those with DC 鈮，

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