【摘要】 目的探讨小儿扩张型心肌病(DCM)预后的影响因素。方法回顾性分析20例DCM病儿的临床资料。结果首次入院时存在心力衰竭者18例(90%),心律失常16例(80%),心源性休克4例(20%)。死亡组(9例)病儿的左心室舒张末期内径(LVDd)及收缩末期内径(LVDs)均大于存活组(11例),左心室射血分数(LVEF)及左心室短轴缩短率(LVFS)均小于存活组,差异均有显著意义(t=2.13～3.25,P<0.05)。死亡组7例存在严重心律失常,存活组仅2例(P=0.028)。Logistic回归单因素分析提示,LVDd、LVDs、LVFS、LVEF及心律失常与预后有关(P=0.014～0.048);多因素分析显示,LVEF是预后的独立预测因素(P=0.018)。结论严重心律失常、低LVEF及LVFS、高LVDd及LVDs提示DCM病儿预后不良,提高LVEF可改善预后。更多还原

【Abstract】 Objective To study the factors affecting prognosis of dilated cardiomyopathy(DCM) in children.MethodsClinical data of 20 children with DCM were retrospectively reviewed.Results Of the 20 sick children reviewed,18(90%) with heart failure at the first admission,16(80%) with arrhythmias,and four(20%)with cardiogenic shock.In death group(9 patients),their left ventricular end diastolic inner diameter(LVDd) and left ventricular end systolic inner diameters(LVDs) were greater than that in survival group(n=11),and their left ventricular ejection fraction(LVEF) and left ventricular fractional shortening(LVFS) were lower(t=2.37-3.25,P<0.05).In the death group,seven had serious cardiac arrhythmias,there were only two in survival group(P=0.028).The logistic regression analysis revealed that the related factors with prognosis were LVDd,LVDs,LVFS,LVEF and arrhythmias(P=0.014-0.048),and multivariate regression analysis indicated that LVEF was an independent factor related to the prognosis(P=0.018).Conclusion The presence of severe arrhythmia,low LVEF,LVFS,high LVDd and LVDs were the predictors for a poor prognosis in children with DCM,raising LVEF can improve their prognosis.更多还原