摘要
目的:分析和总结肥厚型心肌病(HCM)患者的基本临床特征。方法:利用SPSS13.0软件包分析2006-09至2008-09期间连续登记注册的我院门诊和住院患者的临床资料。结果:711例HCM患者平均年龄47岁,男性占67.7%。<14岁患者、>65岁和15～64岁患者所占比例分别是3.4%(24例)、14.3%(102例)和82.3%(585例)。91.3%(649例)为不对称性肥厚,54.8%(373例)为梗阻性肥厚。心肌损伤72.0%(34/47例)表现为心脏核磁的延迟强化。711例HCM患者终末阶段中射血分数<45%和(或)左心室扩大者占2.95%(21)例。心房颤动发生率15.2%(108例),logistic回归分析左心房增大和病史是HCM患者发生房颤的独立影响因素(P均<0.01)。34.7%(24例)患者有心源性猝死,不同风险因素中以晕厥最常见23.7%(159)。并存病中高血压24.8%(175例)和冠心病4.38(31例)、糖尿病2.8%(20例)是较多见的。>65岁老年患者与<65岁患者比其女性、并存病比例高、心功能差等特点,差异均有统计学意义(P均<0.01)。结论:本组病例显示表型HCM患者以青壮年为主,轻、中度心功能下降是患者的主要表现,且梗阻和心房颤动存在对其影响最为突出。室间隔射频消融术可明显改善梗阻症状。
Objective： To analyze and summarize the clinical features of hypertrophic cardiomyopathy（HCM）. Methods： We retrospectively studied 711 HCM patients who were treated in our hospital from 2006 to 2008 for their clinical characteristics with SPSS 13.0 version statistical software. Results ： The patients were at the mean age of 47 years （3mo - 82years）, and 67.7% with male gender. There were 3.4% of patients 〈 14 years of age, 82. 3% of them between 15 -64 years and 14. 3% 〉 65 years. 91.3% of patients suffered from asymmetry septal hypertrophy and 54. 8% with obstructive hypertrophy. Myocardial injury was commonly demonstrated as delayed enhancement on cardiac magnetic imaging（72. 0% ）. Atrial fibrillation（AF） occurred in 15.2% of patients. Left atrial enlarge- ment was the independent risk factor for AF occurrence, P〈0. 01. There were 34. 7% of patients had sudden cardiac death, and the most common risk factor was syncope as 23.7%. The most common combination diseases were hypertension and coronary ar- tery diseases. The elder patients（ 〉65 years of age） usually had worse cardiac function, higher incidence of combination disease and more female gender, P〈0. 01 respectively. Conclusion： Our work reveals that the youth and adult were the major population in HCM patients, their common symptoms are decreased cardiac function, which is especially worse if they combined with obstruction and AF. Radiofrequency catheter abla- tion can obviously improve the obstructive symptom.
出处
《中国循环杂志》
CSCD
北大核心
2011年第6期434-437,共4页
Chinese Circulation Journal
关键词
肥厚型心肌病
临床谱
Hypertrophic cardiomyopathy
Clinical spectrum
