DCM患儿心电图特征及其与心功能分级、心肌病变程度的关系

Electrocardiographic characteristics of children with DCM and its relationship with cardiac function grade and myocardial pathological degree

目的分析扩张型心肌病(DCM)患儿心电图特征及其与心功能分级、心肌病变程度的关系。方法回顾性分析本院112例DCM患儿的临床资料,均行心电图检查,观察患儿心电图特征。比较不同心功能分级、脑钠肽(BNP)、左心室射血分数(LVEF)的患儿心电图改变的差异性。结果 112例患儿心电图均出现不同程度的异常改变,其中以ST-T改变为多见(占71.43%),心电图碎裂QRS波发生率为10.71%,未出现QT间期延长和QRS波时限的改变。不同心功能分级患儿心电图改变情况的比较,并无明显差异(P>0.05)。相比入院时BNP≤150 ng/L者,BNP>150 ng/L患儿碎裂QRS波和窦性心动过速的比例均显著升高(χ2值分别为8.70、5.96,均P<0.05)。相比入院时LVEF>40%者,LVEF≤40%患儿左心室增大的比例明显提高(χ2=9.01,P<0.01)。结论 DCM患儿普遍出现心电图异常改变,且以ST-T段改变为多见,提示心电图检查在一定程度上具有判断儿童DCM的检出、心功能和心肌病变严重程度的临床价值。

Objective To analyze electrocardiographic characteristics of children with dilated cardiomyopathy(DCM) and its relationship with cardiac function grade and myocardial pathological degree.Methods The clinical data of 112 children with DCM in our hospital were analyzed retrospectively.The electrocardiogram examination was performed to observe the electrocardiogram characteristics of the children.To compare the difference of electrocardiographic changes in children with different grades of function,brain natriuretic peptide(BNP) and left ventricular ejection fraction(LVEF).Results The electrocardiogram of 112 children showed abnormal changes in different degrees,most of them were ST-T changes(71.43%).The incidence of QRS wave of electrocardiogram fragmentation was 10.71%.There was no change of QT interval extension and QRS wave time limit.There was no significant difference in electrocardiogram changes of children with different functional grades(P>0.05).Compared with those with BNP≤150 ng/L at admission,the proportion of QRS wave and sinus tachycardia in children with BNP>150 ng/L was significantly increased(χ~2 values were 8.70 and 5.96,respectively.both P<0.05).Compared with those with LVEF>40%,the proportion of left ventricular enlargement in children with LVEF≤40% was significantly increased(χ~2 =9.01,P<0.01).Conclusion Abnormal electrocardiogram changes are common in children with DCM,and ST-T segment changes are more common,suggesting that ECG examination has a clinical value in judging the detection of DCM,cardiac function and severity of myocardial lesions.