特发性室性期前收缩致心肌病的相关因素分析

Related factors analysis of idiopathic ventricular premature contraction induced cardiomyopathy

目的探讨特发性室性期前收缩导致心肌病的相关因素。方法选取2013年1月-2015年12月在我院住院治疗。并行射频消融术的132例频发室性期前收缩患者。排除36例．最终纳入96例。根据室性期前收缩性心肌病的诊断标准，分为心肌病组（观察组）41例和无心肌病组（对照组）55例。记录患者的一般资料及心电图、24h动态心电图及超声心动图的检查指标。对病程、室性期前收缩负荷、室性期前收缩QRS波时程、无症状室性期前收缩、24h平均心室率等影响心动过速性心肌病的因素进行Logistic逐步回归分析。结果多因素分析显示，病程、室性期前收缩负荷、室性期前收缩QRS波时程、无症状室性期前收缩、24h平均心室率为室性期前收缩诱发性心肌病（PVC—ICM）的独立危险因素（OR=1．036，P=0．029；OR=1．041，P=0．005；OR=1．028，P=0．036；OR=2．377，P=0．044；OR=1．006，P=0．018）。结论存在较大的室性期前收缩负荷、较长的病程、较长的室性期前收缩QRS波时程以及无症状的室性期前收缩、24h平均心室率的患者更易发生PVC—ICM。

Objective To investigate the related factors of idiopathic ventricular premature contraction induced car- diomyopathy.Methods From January 2013 to December 2015,132 patients with frequent ventricular premature contrac- tion who planned to acquire radiofrequency catheter ablation in our hospital were selected.Excluded 36 cases,96 cases were included finally.According to the diagnostic criteria of ventricular premature systolic cardiomyopathy,96 cases were divided into observation group （patients with cardiomyopathy,41 cases） and control group （patients with no car- diomyopathy,55 cases）.The general data of the patients were recorded,as well as ECG,24-hour dynamic electrocardia- graphic and the inspection indexes of echocardiogram.The tachycardiomyopathy factors were analyzed by Logistic re- gression analysis,such as course of disease,ventricular premature contraction load,ventricular premature contraction QRS wave duration,asymptomatic ventricular premature contraction,24 h mean ventricular rate etc..Results Multivariate anal- ysis showed that patients easily obtained premature ventricular contraction-induced cardiomyopathy （PVC-ICM） when they had independent factors including long course of disease,ventricular premature contraction load,ventricular prema- ture contraction QRS wave duration,asymptomatic ventricular premature contraction and 24 h mean ventricular rate increasing （OR = 1.036,P=0.029;OR = 1.041,P=0.005;OR = 1.028,P=0.036;OR =2.377,P=0.044 ;OR = 1.006,P=0.018）.Conclusion It is easily to acquire PVC-ICM in patients with pretty large ventricular premature contraction load,long disease course,long ventricular systolic QRS wave duration,and asymptomatie ventricular premature contractions and 24 h mean ventricular rate.