Akita H, Matsuoka S, Kuroda Y
Department of Pediatrics, School of Medicine, University of Tokushima, Japan.
Tokushima J Exp Med. 1993 Jun;40(1-2):55-60.
Electrocardiographic changes were evaluated in 20 patients with a diagnosis of Duchenne's muscular dystrophy (DMD) for a period of 4 to 9 years preceding their death. Certain common electrocardiographic findings were noted in patients during the terminal stage of their disease, and may have prognostic significance. These included: an R wave in lead V1 of less than 0.6 mV, in lead V5 of less than 1.1 mV, and in lead V6 of less than 1.0 mV; abnormal T waves in leads II, III, a VF, V5 and V6; cardiac conduction disturbances; premature ventricular contractions; and sinus tachycardia. A predictive scoring system was proposed based on these findings. The predictive scores for patients who died primarily from cardiac failure were significantly higher than for patients who died primarily from respiratory failure. This score increased to over 10 points as the patient's clinical condition deteriorated. In conclusion, a predictive score is useful in managing patients with DMD, particularly when evaluating for possible cardiac failure.
对20例被诊断为杜氏肌营养不良症（DMD）的患者在其死亡前4至9年期间的心电图变化进行了评估。在疾病终末期的患者中发现了某些常见的心电图表现，这些表现可能具有预后意义。这些表现包括：V1导联R波小于0.6mV，V5导联R波小于1.1mV，V6导联R波小于1.0mV；II、III、aVF、V5和V6导联T波异常；心脏传导障碍；室性早搏；以及窦性心动过速。基于这些发现提出了一个预测评分系统。主要死于心力衰竭的患者的预测评分显著高于主要死于呼吸衰竭的患者。随着患者临床状况恶化，该评分增加到10分以上。总之，预测评分有助于管理DMD患者，尤其是在评估可能的心力衰竭时。
