扩张型心肌病束支传导阻滞与心脏多普勒超声指标、室性心律失常相关关系的研究

The clinical study of relationship among different bundle bronch conduction with Doppler echocardiography ventricular arrhythmia in dilated cardiomyopathy

目的 探讨扩张型心肌病 (DCM)病人束支传导功能状态与心脏多普勒超声指标、室性心律失常的关系。方法 根据 140例DCM病人十二导体表心电图表现分为束支传导功能异常和束支传导功能正常 5组 ,采集临床资料和心脏多普勒超声显像、2 4h动态心电图、X线心脏摄片等检查结果进行组间统计学处理 ,评价束支传导功能状态与心脏多普勒超声指标、室性心律失常及其它临床指标的关系。结果 DCM束支传导异常组 (CLBBB、CRBBB、CRBBB +LAFB)较束支传导功能正常组和单纯LAFB组NYHA心功能分级、X线心胸比、病程年限、心脏多普勒超声指标、Lown氏Ⅲ级以上室性心律失常发生率有显著统计学差异。结论 DCM病人十二导体表心电图束支传导状态与心脏多普勒超声指标、Lown氏Ⅲ级以上室性心律失常相关 ,是评价心功能衰竭、室性心律失常严重程度的一个有效指标 ,对判断病人病程、临床分期、治疗效果。

Objective To study the relationship among different bundle bronch conduction with Doppler echocardiography,ventricular arrhythmia(VA) and other clinical materials in dilated cardiomyopathy(DCM).Methods 140 patients were divided into five groups according to different bundle bronch conduction in 12-leads electrocardiograme(groups CLBBB,CRBBB,CRBBB+LAFB,LAFB and normal bundle bronch conduction NBBC).By receivel clinical materials and measured parameters of Doppler echocardiography,24 hours ambulatory electrocardiograme before drug treatment in every group.The correlation between these data were assessed.Results Using statistic analyses showed that among different bundle bronch conduction groups in patients with DCM,the sick duration,the NYHA functional class,the heart thorax ratio,ther LV end-diastotic and end -systolic volume,the LV ejection fraction,the peak E velocity,E/A ratio and above I owns Ⅱ degree VA in groups CLBBB,CRBBB,CRBBB+LAFB were more serious than those in groups LAFB and NBBC Conclusion Our data provide relevant information among different bundle bronch conduction groups,CLBBB、 CRBBB and CRBBB+LAFB are associated with the risk parameters of Doppler echocardiography,ventricular arrhythmia. [