扩张型心肌病心室重构伴充血性心力衰竭的危险因素分析

Analysis of risk factor about ventricular remodeling of dilated cardiomyopathy with congestive heart failure

目的:探讨扩张型心肌病(DCM)后心室重构(VRM)伴充血性心力衰竭(CHF)的危险因素。方法:选择DCM患者NYHA分级Ⅱ～Ⅳ级,且左心室射血分数(LVEF)<40%的96例为观察组;心功能Ⅰ级,LVEF≥40%的35例患者为对照组,比较2组临床资料,在单因素分析基础上,采用Logistic多因素逐步分析方法确立DCM后VRM伴CHF的独立危险因素。结果:单因素分析结果显示,观察组中男性患病率、心房颤动(房颤)及脉压≥70mmHg(1mmHg=0.133kPa)者较对照组高,差异有统计学意义(P<0.01)。Logistic逐步回归分析脉压≥70mmHg、房颤为DCM后VRM伴CHF的独立危险因素。结论:脉压≥70mmHg、房颤是DCM后VRM伴CHF的独立危险因素。

Objective：To investigate the risk factor of ventricular remodeling（VRM） after dilated cardiomyopathy（DCM） with ventricular congestive heart failure（CHF）. Method：96 patients NYHA grade Ⅱ-Ⅳ with LVEF 40% were selected as observation group,and the rest 35 patients NYHA grade Ⅰ with LVEF≥40% were selected as control group.Clinical data was compared.On the base of the single factor analysis,Logistic stepwise analysis was used to establish its independent risk factors. Result：Univariate analysis showed that compared with the control group,male prevalence,atrial fibrillation,pulse pressureare ≥70 mmHg were significantly increased in observation group（P0.01）.Logistic stepwise analysis displayed that pulse pressureare ≥70 mmHg and atrial fibrillation were independent factors in observation group. Conclusion：Pulse pressureare ≥70 mmHg and atrial fibrillation are independent risk factors of VRM after DCM with CHF.