摘要
目的:探讨肥厚型心肌病(hypertrophic cardiomyopathy,HCM)患者扩张相的特征与生存状况。方法:选取2008-04-2011-08我院收治的HCM患者496例,依据诊断结果分为扩张相组(18例)和对照组(478例),比较2组患者的临床特征和1年、3年、5年生存率,并进行COX回归分析。结果:扩张相组患者的心房颤动(房颤)、猝死、NYHA分级Ⅲ~Ⅳ级、束支传导阻滞比例明显高于对照组,左心室舒张末期内径(LVEDD)、左房最大容积(LAVmax)、左房前后径(LAD)、左室壁厚度(LVWH)水平显著高于对照组,左室射血分数(LVEF)明显低于对照组,以上差异均有统计学意义(P<0.05)。扩张相组1年、3年、5年生存率分别为94.44%、77.78%、61.11%;对照组1年、3年、5年生存率分别为97.07%、93.93%、89.96%。随访结束时,扩张相组2例患者进展为扩张期,7例死亡[2例死于心力衰竭(心衰),5例猝死];对照组中21例进展为扩张期,48例患者死亡(10例死于心衰,38例猝死)。房颤、猝死、NYHA分级Ⅲ~Ⅳ级、LVEF<50%是影响HCM患者扩张相生存状况的独立危险因素(P<0.05)。结论:HCM患者扩张相的主要临床特征为房颤,猝死,NYHA分级Ⅲ~Ⅳ级,束支传导阻滞,LVEDD、LAVmax、LAD、LVWH升高和LVEF降低,患者长期生存状况不佳,其中房颤、猝死、NYHA分级Ⅲ~Ⅳ级、LVEF<50%是影响患者生存状况的独立危险因素。
Objective：To explore the characteristics and survival of patients with hypertrophic cardiomyopathy.Method：Selected 496 patients with hypertrophic cardiomyopathy from April 2008 to August 2011 in our hospital.Those patients were divided into the expansion phase group（n=18）and control group（n=478）,according to the diagnosis.We compared two group＇s i patie clinical characteristics and 1-year,3-year,5-year survival rate,and analyzed usingand COX regression.Result：The expansion phase group of patients with atrial fibrillation,sudden death,NYHA gradeⅢ ~ Ⅳ grade,bundle branch block,LVEDD,LAVmax,LAD,LVWH was significantly higher than those of control group,but LVEF was significantly lower.The above differences were statistically significant（P〈0.05）.In expansion phase group,1-year,3-year,5-year survival rates were 94.44%,77.78%,61.11%,respectively;while in control group,1-year,3-year,5-year survival rates were 97.07 percent,93.93 percent,89.96%,respectively.At the end of the follow-up,there were 2cases developed to expansion period,7patients died,2cases died of heart failure,5cases of sudden death in the expansion phase group;21cases developed to expansion period,48 patients died,10 cases died of heart failure,38 cases of sudden death in control group.Atrial fibrillation,sudden death,NYHA gradeⅢ~Ⅳ class,LVEF50% were independent risk factors in the expansion phase group（P〈0.05）.Conclusion：The major clinical feature in expansion phase group of patients with hypertrophic cardiomyopathy is the atrial fibrillation and sudden death,NYHA gradeⅢ~Ⅳ,bundle branch block,LVEDD,LAVmax,LAD,LVWH increased and LVEF decreased.Atrial fibrillation,sudden death,NYHA gradeⅢ~Ⅳ,LVEF〈 50% are independent risk factors.
作者
丁春丽
DING Chunli(Department of Cardiology, the First Affiliated Hospital of Nanyang Medical College,Nanyang, 473000, Chin)
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2017年第2期133-136,共4页
Journal of Clinical Cardiology
关键词
肥厚型心肌病
扩张相
临床特征
生存状况
hypertrophic cardiomyopathy
expansion phase
clinical features
living conditions
