早搏与心功能的关系及影响因素的研究

Impactofprematurebeatoncardiacfunctioninchildren

为探讨小儿早搏对心功能的影响，采用多普勒超声心动图测定４０例早搏患儿的单个早搏射血分数（ＰＢＥＦ）、心脏指数（ＰＢＣＩ）；单个非早搏的射血分数（ＮＰＢＥＦ）、心脏指数（ＮＰＢＣＩ）及实际的射血分数（ＡＥＦ）、心脏指数（ＡＣＩ）。同时研究这些指标与心电图和心肌酶的关系。结果显示：（１）早搏患儿ＰＢＥＦ、ＰＢＣＩ均小于ＮＰＢＥＦ、ＮＰＢＣＩ；病程长者ＰＢＥＦ、ＡＥＦ及ＡＣＩ均下降；室性早搏者的ＡＣＩ减少；早搏＞１０次／分者的ＡＥＦ及ＡＣＩ下降；Ｒ－Ｒ′／Ｒ－Ｒ比值小者的ＰＢＥＦ、ＡＥＦ及ＰＢＣＩ亦小；早搏ＱＲＳ－Ｔ综合波长者的ＰＢＥＦ及ＰＢＣＩ减少。（２）肌酸磷酸激酶同功酶（ＣＫ－ＭＢ）升高者的ＰＢＥＦ、ＡＥＦ、ＰＢＣＩ、ＡＣＩ均值的下降比ＣＫ－ＭＢ不升高者显著。研究提示，早搏＞１０次／分、Ｒ－Ｒ′／Ｒ－Ｒ＜０．６、ＱＲＳ－Ｔ综合波＞０．４秒和ＣＫ－ＭＢ＞１６ＩＵ／Ｌ者的心功能多受到影响，应予以积极治疗。

Thepresentstudywasundertakentoclarifyifprematurebeatsinfluencethecardiacfunctioninchildren.Prematurebeatejectionfraction(PBEF),prematurebeatcardiacindex(PBCI),non-prematurebeatejectionfraction(NPBEF),non-prematurebeatcardiacindex(NPBCI),actualejectionfraction(AEF)andactualcardiacindex(ACI)wereexaminedin40childrenwithprematurebeatbyDopplerechocardiography.TheresultsshowedthatPBEFandPBCIofchildrenwithprema-turebeatwerebothdecreased.Theheartfunctioncouldbeinfluencedinthosewithalongcouresofprematurebeat,thenumberofprematurebeatmorethan10/min,lowR-R′/R-R,longQRS-Tcom-plexandincreasedserumCK-MB.Acordingtoourrecearch,thepatientsshouldbeactivelytreatedincasethenumberofprematurebeatismorethan10/min,serumCK-MBlevelishigherthan16IU/L,R-R′/R-Rislowerthan0.6andthetimeofQRS-Tcomplexislongerthan0.4sec.