心肌炎心肌病患者的早搏后强化作用临床研究

CLINICAL STUDY OF POSTEXTRASYSTO LIC P0TENTIATION IN THE PATIENTS WITH CARDIOMYOPATHIES AND MYOCARDITIS

用食管心房起搏诱发早搏及心阻抗血流图检测正常人、心肌炎、心肌病早搏后强化程度指标RCdz/dt、RH1、ΔQ-Z、ΔPEP、ΔLVET、ΔPEP/LVET。发现在同一基础兴奋间期(SI),三组各指标与早搏联律间期(CI)成反比,与早搏后间期(PI)成正比;而在同一SI、CI、PI,各指标在心肌病组>心肌炎组>正常人。RCdz/dt,ΔPEP/LVET在心肌病组与左室舒张末期内径密切相关(r=0.94、0.96,P<0.01),阳性率为87％、93％。在心肌损害较轻的心肌炎组阳性率为67％、87％。在正常人中的假阳性率为10％、0。表明本法是一种安全、简便、敏感、可靠的评定心肌疾病心功能的新方法。

By using extrasystole induced by transesophageal pacing combined with the differential impedance cardiogram, the indices of postextrasystolic potentiation degree ( RPESP ) RCdz/dt, RHI, Q-Z, PEP, LVET and PEP/LVET were observed in the normal persons and the pateints with cardiomyopathies and myocarditis. The results show that PRESP is in direct proportion to the postextrasystolic interval (PI) and in inverse proportion to the couple interval ( CI ) at the same static interval ( SI) . RPESP of the cardiomyopathies group is remarkedly higher than that of the myocarditis and of the normal subjects at the same SI, CI and PI. RCdz/dt and PEP/LVET have a good correlation with the left ventricular end djastolic diameter (r = 0.94, 0.96 respectively, P<0.01) and a high positive rate (87% and 90%, respectively) in the patients with cardiomyopathies. The false positive rates of RCdz /dt and PEP/LVET are low (10% and 0, respectively in the normal subjects) . Therefore the method is a safe, simple, sensitive, reliable and new way for the assessment of the myocardial disease.