单纯性心动过速性心肌病临床特点及危险因素分析

doi:10.12114/j.issn.1007-9572.2018.00.406

摘要/Abstract

摘要： 背景　单纯性心动过速性心肌病（pTCM）的发病率较高，但对于pTCM与扩张型心肌病（DCM）的鉴别诊断及其发病的危险因素目前尚无较系统的研究。目的　探讨pTCM的临床特点和发病危险因素。方法　入选2016年1月—2017年12月在宁波市鄞州第二医院心内科住院的pTCM患者为pTCM组（42例），并选取同时期在本院住院的DCM患者为DCM组（43例）、同时期在本院就诊的有心动过速但无心动过速性心肌病患者为对照组（57例），采集患者的病史、入院后临床资料、血液学检查及其他辅助检查结果。比较pTCM组与DCM组患者的性别、年龄、吸烟史、有无高脂血症史及N末端脑钠肽前体（NT-proBNP）、左心房内径、左心室舒张末期内径、左心室射血分数。比较pTCM组与对照组的性别、年龄、体质指数（BMI）、吸烟史、高脂血症病史、心肌肌钙蛋白I（cTnI）、24 h动态心电图（Holter）总心率、心动过速类型、心动过速占总心率的百分比；采用多因素Logistic回归分析分析pTCM发病的危险因素。结果　pTCM组年龄、左心室射血分数、左心房内径高于DCM组，NT-proBNP低于DCM（P<0.05）。pTCM组cTnI、24 h Holter总心率、心动过速占总心率的百分比均高于对照组（P<0.05）。多因素Logistic回归分析结果显示，cTnI、24 h Holter总心率、心动过速占总心率的百分比是pTCM发病的影响因素（P<0.05）。结论　pTCM对患者的左心室结构和功能的影响要小于DCM，患者年龄较DCM患者偏大，pTCM发病的危险因素为cTnI和24 h Holter总心率、心动过速占总心率的百分比。

关键词: 心肌疾病；心动过速；心肌病, 扩张型；心室射血数；肌钙蛋白I；影响因素分析

Abstract: Background　The morbidity of pure tachycardia-induced cardiomyopathy（pTCM） are improving，the differential diagnosis between pTCM and dilated cardiomyopathy（DCM），as well as risk factors of pure tachycardia-induced cardiomyopathy are still not studied systematically.　Objective　To investigate the clinical characteristics and independent risk factors of pTCM.Methods　This study enrolled 42 pTCM inpatients（pTCM group）from Cardiovascular Department，Ningbo Yinzhou No.2 Hospital，from January 2016 to December 2017. They were compared to 43 dilated cardiomyopathy inpatients（DCM group）as well as 57 outpatients with tachycardia but without tachycardia-induced cardiomyopathy（tachycardia group） receiving treatment in the same hospital during the same period.Medical history，clinical data，results of hematological examination and other auxiliary examinations were collected. Comparisons were made between pTCM and DCM groups in terms of sex，age，smoking history，hyperlipidemia history， NT-proBNP，left atrial diameter（LAD），left ventricular end-diastolic dimension（LVDd），left ventricular ejection fraction（LVEF），and between pTCM and control groups in respect of sex，age，body mass index，smoking history，hyperlipidemia history，cardiac troponin I（cTnI），total heart rate measured by 24-hour Holter monitoring，type of tachycardia and percentage of tachycardia. Multivariate Logistic regression analysis was carried out to explore the risk factors of pTCM. Results Compared to the DCM group，pTCM group had greater average age，and higher LVEF，LVD values，and lower NT-proBNP value（P<0.05）． pTCM group showed higher cTnI value，more 24-hour total heart rate，higher percentage of tachycardia than tachycardia group（P<0.05）． Multivariate Logistic regression analysis found that the independent risk factors of pTCM were cTn-I value，24-hour total heart rate，percentage of tachycardia （P<0.05）．Conclusion　Compared to DM patients，pTCM patients are older，have less injury in left ventricular structure and function. The independent risk factors of pTCM are cTnI value，24-hour total heart rate，and percentage of tachycardia.

Key words: Cardiomyopathies；Tachycardia；Cardiomyopathy, dilated；Ventricular ejection fraction；Troponin I；Root cause analysis

俞丽,陈婷,李丹. 单纯性心动过速性心肌病临床特点及危险因素分析[J]. 中国全科医学, 2019, 22(12): 1485-1487. DOI: 10.12114/j.issn.1007-9572.2018.00.406.
YU Li,CHEN Ting,LI Dan. Clinical Characteristics and Independent Risk Factors of Pure Tachycardia-induced Cardiomyopathy　[J]. Chinese General Practice, 2019, 22(12): 1485-1487. DOI: 10.12114/j.issn.1007-9572.2018.00.406.

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