章丽云++++++马双

[摘要]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、24 h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、24 h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、24 h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、24 h平均心室率的患者更易发生PVC-ICM。

[关键词]特发性室性期前收缩；心肌病；射频消融术；相关因素

[中图分类号] R542.2 [文献标识码] A [文章编号] 1674-4721（2016）10（c）-0036-05

[Abstract]Objective To investigate the related factors of idiopathic ventricular premature contraction induced cardiomyopathy.Methods From January 2013 to December 2015，132 patients with frequent ventricular premature contraction 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 cardiomyopathy，55 cases）.The general data of the patients were recorded，as well as ECG，24-hour dynamic electrocardiagraphic and the inspection indexes of echocardiogram.The tachycardiomyopathy factors were analyzed by Logistic regression 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 analysis 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 premature 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 asymptomatic ventricular premature contractions and 24 h mean ventricular rate.

[Key words]Idiopathic ventricular premature contraction；Cardiomyopathy；Radiofrequency catheter ablation；Related factors

室性期前收缩是临床上较为常见的心律失常，可发生在器质性心脏疾病或心功能不全患者中，也可见于无明确心血管疾病的人群中。将非器质性心脏病患者出现的室性期前收缩称为特发性室性期前收缩。既往认为特发性室性期前收缩是良性的心律失常，对心血管疾病没有预测价值[1]。随着对室性期前收缩治疗效果的提高，室性期前收缩消除后，在心脏无器质性病变患者中发现其心功能及心脏腔径较治疗前有所恢复，因此，认为长期频发的室性期前收缩可激发和损害心脏功能，进而导致心肌病。……