频发室性早搏与心肌炎的关系及其对心功能的影响

Relationship between multiple ventricular premature beat and myocarditis and the influence to cardiac function

目的探讨频发室性早搏(MVPB)与心肌炎的关系及其对心功能的影响。方法对53例单纯MVPB(下称MVPB组)和55例心肌炎并MVPB组患儿进行多普勒超声心动图、心室晚电位(VLP)及血清柯萨奇BIgM(CoxBIgM)抗体、肌酸激酶心肌同功酶(CK-MB)和α羟丁酸脱氢酶(αHBDH)检测。结果MVPB组CoxBIgM抗体阳性率为30.2%,显著低于心肌炎并MVPB组(61.8%),显著高于正常儿童(7.5%)。MVPB组CK-MB、αHBDH显著高于正常儿童。MVPB组早搏>10次/min患儿的心脏射血分数和心脏指数显著降低,3例VLP阳性(其中2例发生室性心动过速)。结论部分单纯MVPB患儿与心肌炎有关,可影响心功能,应使用抗心律失常药物治疗。

Objective To study the relationship between multiple ventricular premature beat (MVPB) and myocarditis and the influence to cardiac function.Methods The EKG Dopple echocardiography(ECHO) ventricular late potential(VLP) and the CoxBIgM cardiac isoenzyme of creatine phosphokinas(CK-MB) and αhydroxybutyric dehydrogenase(αHBDH) were examed in the 53 cases with simple MVPB and 55 cases with myocarditis complicated with MVPB.Results CoxBIgM positive rate was significantly higher in myocarditis with MVPB(61.8%) than in simple MVPB (30.2%) and it was significantly higher in simple MVPB than in normal hildren (7.5%).CK-MB and αHBDH was significantly higher in simple MVPB than in normal children.Ejection fraction (EF) and cardiac index (CI) were significantly lower in patients with MVPB than in normal children.The VLP of 3 cases with MVPB was positive and ventricular tachycardia was happen later in 2 of these 3 cases.Conclusion Partial cases with simple MVPB were related to myocarditis and simple MVPB should be treated by antiarrhythmic medicines.