【摘要】 目的　探讨心区交感神经阻滞能否降低心肌病患者的QT间期离散度 (QTd)及年病死率。方法　符合WHO诊断标准的扩张型心肌病 60例 ,随机分成治疗组与对照组。治疗组实施心区交感神经阻滞 ,于硬膜外腔推注 0 .5%利多卡因 3 5ml ,间隔时间 2h ,阻滞平面为胸 1～ 5,辅以常规药物治疗 ,如洋地黄、利尿剂、血管扩张剂及血管紧张素转换酶抑制剂 (ACEI)等 ,对照组仅给予常规药物治疗。于治疗前及治疗后 4周人工测量QTd。观察 48例心功能IV级 (NYHA分级 )患者 1年病死率。结果　治疗组QTd显著降低 (P <0 .0 5) ,对照组QTd略降低 (P >0 .0 5)。 48例心功能IV级患者经心区交感神经阻滞治疗后 1年死亡 11例。结论　心区交感神经阻滞能有效降低心肌病患者QTd ,并能降低年病死率更多还原

【Abstract】 ObjectiveTo explore the effects of cardiac s ympathetic nerve blockade on QT interval dispersion and one mortality of patient s with cardiomyopathy.MethodsSixty patients with dilated cardiomyopathy were recruited and randomly divided into therapy group and control group with 30 pat ients in each group. Patients in therapy group, were administered cardi ac sympathetic nerve blockade by intermittent injection of 0.5% lidocaine 3~5 ml every 2 hours in addition to routine treatment,while patients in control group received routine treatment. QTd was measured and calculated before and 4 weeks a fter undergoing cardiac sympathetic nerve blockade. Forty eight cases of dilated cardiomyopathy with NYHA cardiac function class IV were observed prospectively for evaluation of one-year mortality.ResultsQTd in patients in therapy group was reduced si gnificantly (P<0.05) .While QTd in control group was not changed signific antly (P>0.05). Eleven of 48 cases with cardiac function in class Ⅳ were de ad one year after experiencing cardiac sympathetic nerve blockade.ConclusionsCardiac sympathetic nerve blockade can redu ce QTd in patients with cardiomyopathy and one-year mortality significantly.更多还原