学龄前和学龄期儿童希氏束以上心动过速性心肌病高危因素分析

目的探讨学龄前和学龄期儿童希氏束以上的心动过速(室上性心动过速)与心动过速性心肌病的相关性及高危因素.方法选取室上性心动过速患儿179例,根据心动过速时心功能状态分为心肌病组23例,非心肌病组156例.分析患儿性别、年龄、发作类型、发作频率、持续时间、心室率与心功能损伤的关系和相关高危因素.结果 179例患儿中心动过速性心肌病23例,其中房室折返性、房室结折返性、无明确分类的心肌病分别为7例、10例、6例.房速所致心动过速性心肌病发生率为25.00%(8/32),明显高于阵发性室上性心动过速所致的心肌病发生率10.20%(15/147),差异具有统计学意义(P0.05).心肌病组患儿中房速所占比例、发作持续时间明显高于非心肌病组患儿,发作频率明显低于非心肌病组患儿,差异均具有统计学意义(P0.05).二元Logistic回归分析显示:发作持续时间是心动过速性心肌病的独立影响因素.结论学龄前和学龄期儿童室上性心动过速所致心动过速性心肌病的发生率为12.85%,其中房速所致的心肌病发生率明显高于阵发性室上性心动过速,发作持续时间是唯一高危因素.

On High Risk Factors of Tachycardiomyopathy above HSI Bundle in preschool and School-age Children

Objective To explore the correlation and risk factors of tachycardiomyopathy and supraventricular tachycardia in preschool and school-age children.Method A total of 179 cases of supraventricular tachycardia patients were selected in this study.According to the heart function state in tachycardia,the children were divided into 23 cases of cardiomyopathy group and 156 cases of non-cardiomyopathy group.The relationship between sex, age,type of attack,frequency of seizures,duration,ventricular rate and cardiac dysfunction and related risk factors were analyzed.Results Among the 179 cases,23 cases had central hyperkinetic cardiomyopathy,in which the number of atrioventricular reentrant,atriove ntricular nodal reentrant and no definite classification of cardiomyopathy were 7 cases,10 cases and 6 cases,respectively.The incidence of tachycardia cardiomyopathy caused by atrial tachycardia was 25.00%,which was significantly higher than the incidence of cardiomyopathy caused by paroxysmal supraventricular tachycardia(10.20%)(P<0.05).The proportion of atrial tachycardia and the duration of seizure in the cardiomyopathy group were significantly higher than those in the non cardiomyopathy group,and the frequency of seizures was significantly lower than that in the non cardiomyopathy group(P<0.05).Binary Logistic regression analysis showed that the duration of seizures was an independent factor in tachycardia cardiomyopathy. Conclusion The incidence of tachycardia cardiomyopathy caused by supraventricular tachycardia in preschool and school-age children was 12.85%.The incidence of cardiomyopathy induced by atrial tachycardia was significantly higher than that caused by paroxysmal supraventricular tachycardia.The duration of seizure was the only risk factor.