儿童室性心动过速生存率及预后影响因素的分析

Survival Analysis and Prognostic Determinants in Children with Ventricular Tachycardia

目的分析儿童室性心动过速 (VT)生存率及影响预后的因素。 方法对 1993年 2月至 2 0 0 2年 12月资料完整的 32例VT患者进行随访 ,用Kaplan -Meier法行生存分析。 结果 32例VT存活 2 0例 ,死亡 12例。VT后生存曲线逐月下降 ,2周 ,2、6、12月生存率分别为 71.8%、6 8.8%、6 5 .6 %、6 2 .5 %。患病年龄、原发心脏疾病、合并心功能衰竭、持续性VT、多形VT、药物治疗效果在死亡与存活患儿之间有显著差异 (P <0 .0 1)。 结论伴严重器质性心脏病、合并心功能衰竭、持续性VT、多形VT、药物治疗无效是影响预后的危险因素 。

Objective To analyze the survival outcome and risk factors of prognosis in children with ventricular tachycardia(VT). Methods The study 32 patients with ventricular tachycardia from Fe bruary 1993 to December 2002.A survival analysis was performed according to the Kaplan-Meier method. Results There were 12 deaths and 20 survivors during the study period. By Kaplan-Meier survival analysis, the survival rates at 2 weeks, 2, 6,12 months were 71.8%, 68.8%, 65.6%, 62.5%, respectively. By Log Rank test statistics sixteen factors were compared between deaths and survivors. Patients with underlying heart disease and those with serious symptoms such as heart failure were significant risk factors of mortality VT. Children younger than 3 years had a worse prognosis. Both sustained and polymorphic VT were predictive factors closely related to a poor outcome. Failure of pharmacologic therapy also carried a worse prognosis ( P <0.01) . Conclusion Children with a diagnosis of VT and heart diseases are at a potential risk. Heart failure was the risk factor for death. The outlook for children with sustained VT and polymorphic VT is poor if the arrhythmia can not be controlled by treatment. However, a long-term follow-up of the VT children is necessary.