扩张型心肌病合并完全性左束支传导阻滞对心功能的影响及危险因素分析

Influence of dilated cardiomyopathy complication complete left bundle branch block(CLBBB) on heart function and analysis of risk factors

目的 探讨完全性左束支传导阻滞（CLBBB）对扩张型心肌病患者的心功能的影响。方法选择52例扩张型心肌病住院患者,将其分为合并完全性左束支传导阻滞组21例、正常窦性心律组31例,所有患者进行超声心动图检查,并对心脏结构和功能进行比较。结果 与正常窦性心律组相比,CLBBB组患者年龄、左室收缩末内径（LVESD）、左室舒张末内径（LVEDD）均大于正常窦律组（P〈0.01）;CLBBB组患者室间隔厚度（IVSd）、左室射血分数（LVEF）均小于正常窦律组（P〈0.05,P〈0.05）。年龄、LVESD及LVEDD分别与CLBBB呈正相关（r=0.541,P=0.000;r=0.398,P=0.012;r=0.404,P=0.009）;IVSd与CLBBB呈显著负相关（r=-0.354,P=0.019）;LVEF与CLBBB无相关性（r=-0.288,P=0.061）。二分类Logistic回归分析结果显示年龄和LVEDD为CLBBB发生的预测因素（P=0.027,OR=1.196,95%CI：1.020~1.402;P=0.018,OR=1.224,95%CI：1.035~1.447）。结论 完全性左束支传导阻滞会加重扩张型心肌病患者左心室功能的损害,年龄和左室舒张末内径可能为扩张型心肌病患者CLBBB发生的危险因素。

Objective To investigate the influence of complete left bundle branch block （CLBBB） on heart function in patients with dilated cardiomyopathy. Methods The patients （n=52） were chosen and divided into CLBBB group （n=21） and normal sinus rhythm （NSR） group （n=31）. All patients were given echocardiogram examination, and the cardiac structure and function were compared between 2 groups. Results Age, LVESD and LVEDD were higher in CLBBB group compared with NSR group （P〈0.01）. IVSd and LVEF were lower in CLBBB group compared with NSR group （P〈0.05, P〈0.05）. Age, LVESD and LVEDD were positively correlated to CLBBB （r=0.541, P=0.000;r=0.398, P=0.012;r=0.404, P=0.009）, and IVSd was negatively correlated to CLBBB （r=-0.354, P=0.019）. LVEF was not correlated to CLBBB （r=-0.288, P=0.061）. The results of binary Logistic regression analysis showed that age and LVEDD were predictive factors of CLBBB occurrence （P=0.027, OR=1.196, 95%CI：1.020~1.402;P=0.018, OR=1.224, 95%CI：1.035~1.447）. Conclusion CLBBB will aggravate the impairment of left ventricular function in patients with dilated cardiomyopathy, and age and LVEDD may be the risk factors of CLBBB occurrence.