频发室性期前收缩所致心肌病患者心功能变化及治疗分析

Heart Function Changes of Frequent Premature Ventricular Contractions-induced Cardiomyopathy and Its Treatment

目的：分析频发室性期前收缩所致心肌病（ PVCs-ICM）患者心功能变化及治疗，提高临床医生对PVCs-ICM的诊治水平。方法选取2012—2013年在梅州市人民医院心内科行射频消融术（ RFCA）治疗的频发室性期前收缩患者128例，根据PVCs-ICM发生情况分为观察组57例（并发PVCs-ICM）和对照组71例（未并发PVCs-ICM）。两组患者均于RFCA治疗后随访6～9个月，比较两组患者RFCA治疗效果；观察两组患者治疗前左室射血分数（ LVEF）、左室舒张末期内径（ LVEDD）、室性期前收缩负荷量、QRS 波宽度及观察组患者治疗6个月后 LVEF、LVEDD、室性期前收缩负荷量改善情况。结果观察组患者RFCA治疗有效率为84.2％，对照组为84.5％，差异无统计学意义（P﹥0.05）。观察组患者治疗前LVEF低于对照组，LVEDD、室性期前收缩负荷量、QRS波宽度高于对照组（P﹤0.05）。观察组患者治疗6个月后LVEF高于治疗前，LVEDD、室性期前收缩负荷量低于治疗前（P﹤0.05）。结论 PVCs-ICM患者心功能明显降低，室性期前收缩负荷量明显增高，QRS波明显增宽，RFCA治疗可有效改善PVCs。

Objective To analyze heart function changes of frequent premature ventricular contractions -induced cardiomyopathy（PVCs - ICM）and its treatment. Methods From 2012 to 2013,a total of 128 patients with frequent premature ventricular contractions were selected in the Department of Cardiology,People＇s Hospital of Meizhou,all of them were given radiofrequency catheter ablation（ RFCA）,and they were divided into observation group（ complicated with PVCs-ICM, n=57）and control group（uncomplicated with PVCs-ICM,n=71）according to the incidence of PVCs-ICM. Patients of both groups were followed-up for 6 to 9 months,and the therapeutic effect was compared. LVEF,LVEDD,load capacity of premature ventricular beats and QRS complex width were compared between the two groups before treatment;and the improvement of LVEF,LVEDD,load capacity of premature ventricular beats of observation group after 6 months of treatment was observed. Results The effective rate of RFCA of observation group was 84. 2%, that of control group was 84. 5%, the difference was not statistically significantly different（P﹥0. 05）. LVEF of observation group was lower than that of control group before treatment,while LVEDD,load capacity of premature ventricular beats and QRS complex width were higher than those of control group before treatment（P﹤0. 05）. After 6 months of treatment,LVEF of observation group was statistically significantly higher than that before treatment,while LVEDD and load capacity of premature ventricular beats were statistically significantly lower than those before treatment（P﹤0. 05）. Conclusion Heart function of patients with PVCs-ICM is obviously decreased, the load capacity of premature ventricular beats are obviously increased,QRS complex width is obviously widened,and RFCA can effectively improve the patients＇heart function.