| 刘晓婷 黄美容 傅立军 郭颖 刘廷亮 张玉奇 钟玉敏 吴兰平 朱俊学 徐欣怡 章旭 刘春晓 石琳 高伟 李奋 陈树宝.儿童不明原因扩张型心肌病左室射血分数恢复的影响因素分析[J].,2017,17(6):1163-1167 |
| 儿童不明原因扩张型心肌病左室射血分数恢复的影响因素分析 |
| Analysis of the Influencing Factors of Recovery of Left Ventricular EjectionFraction in Children with Idiopathic Dilated Cardiomyopathy |
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| DOI： |
| 中文关键词: 扩张型心肌病 预后 儿童 |
| 英文关键词: Dilated cardiomyopathy Prognosis Children |
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| 中文摘要: |
| 目的：探讨儿童不明原因扩张型心肌病(DCM)左室射血分数(LVEF)恢复的影响因素。方法：回顾性分析2010 年1 月至2014
年12 月在我院住院治疗的不明原因DCM患儿的临床资料，对所有患者随访16 月后，根据二维超声心动图(UCG)中LVEF值，分
为LVEF 恢复组、未恢复组和死亡组，比较各组之间各相关检测指标的差异。结果：入选194 例患者，男性113 例。恢复组45 例
(23.20%)，未恢复组65 例(33.51%)，死亡组84 例(43.29%)。恢复组发病年龄≤ 2 岁者患者比例明显高于未恢复组与死亡组(P 均
<0.05)。初诊时，恢复组左室舒张末期内径(LVDD)明显小于未恢复组与死亡组，LVEF 明显高于未恢复组与死亡组(P 均<0.05)。恢
复组二尖瓣轻度反流的患者明显多于未恢复组及死亡组(P 均<0.05)。恢复组室性心律失常者比例明显少于未恢复组及死亡组
(P<0.05)。恢复组患者无心肌延迟强化现象，未恢复组延迟强化占5.41%，死亡组占21.74%。恢复组LVEF 恢复正常的中位时间
8.0 月，同时有LVDD恢复正常者11 例。多因素分析发现年龄>2.0 岁(OR=17.064，95%CI3.494-83.171，P=0.000)、心功能III-IV 级
(OR=17.711，95%CI2.229-140.704，P=0.007)、MR中重度反流(OR=3.762，95%CI1.209-11.706，P=0.022)是LVEF不能恢复正常的独
立危险因素。结论：年龄>2.0 岁、心功能III-IV级、二尖瓣中重度反流是不利于儿童不明原因扩张型心肌病患儿LVEF 恢复的独
立危险因素。 |
| 英文摘要: |
| Objective:To explore the influencing factors of recovery of left ventricular ejection fraction (LVEF) in children with
idiopathic dilated cardiomyopathy (DCM).Methods:The clinical data of idiopathic dilated cardiomyopathy patients were retrospectively
analyzed from January 2010 to December 2014. All patients were followed up for 16 months. According to the left ventricular ejection
fraction (LVEF) detected by two-dimensional echocardiography (UCG), the patients were divided into 3 groups: LVEF recovery group,
non recovery group and death group. The difference of each correlation detection index were compared between three groups.Results:194 patients were selected, including 113 cases of male. There were 45 cases in the recovery group (23.20%), 65 cases in the non
recovery group (33.51%), 84 cases (43.29%) in the death group. The percentage of patients （≤ 2 years）in recovery group were
significantly higher than those of non recovery group and death group (P <0.05). At the first visit, the left ventricular end diastolic
diameter (LVDD) of recovery group was significantly smaller than that of the non recovery group and the death group, and the LVEF was
significantly higher than those in the non recovery group and the death group (P all <0.05). The percentage of patients with mitral
regurgitation in recovery group were significantly higher than those in the non recovery group and the death group (P<0.05). The
percentage of ventricular arrhythmias in the recovery group were significantly less than those in the non recovery group and the death
group (P<0.05). Cardiac magnetic resonance examination was performed in 87 patients (44.85%). There was no myocardial delayed
enhancement in the recovery group, and 5.41% in the no recovery group and 21.74% in the death group. In recovery group, the LVEF
restore the normal median time 8 months. There were 11 cases of LVDD recovery. Multivariate analysis showed that age higher than 2.0
years old (OR=17.064, 95%CI3.494-83.171, P=0.000), cardiac function grade III-IV (OR=17.711, 95%CI2.229-140.704, P = 0.007), Mr
severe reflux (OR=3.762, 95%CI1.209-11.706, P = 0.022) were independent risk factors of LVEF unrecovery.Conclusion:Some of children with idiopathic dilated cardiomyopathy, LVEF could return to normal after active treatment. Age >2.0 years old, heart function
III-IV level, mitral valve in the severe reflux were the independent risk factors of LVEF unrecovery in children with idiopathic dilated
cardiomyopathy. |
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