CAJ | 학술논문

目的：通过与典型的肥厚型心肌病( HCM)比较,探讨心尖肥厚型心肌病( AHCM)的临床及心脏超声特点。方法回顾性收集90例HCM住院患者的临床资料,分成3组进行比较。 AHCM组：AHCM 26例。典型HCM患者(室间隔以及左心室壁肥厚),根据是否存在流出道梗阻分成二组,即非梗阻性肥厚型心肌病( NOHCM)组39例；梗阻性肥厚型心肌病( OHCM)组25例。比较三组患者的临床症状、心脏超声特点。结果 AHCM组患者的发病年龄较OHCM组晚[(48.9±12.6)岁VS.(38.5±12.0)岁,P<0.01],无猝死家族史,临床症状轻,较少出现劳力性呼吸困难,血浆心肌酶中肌酸激酶同工酶(CK-MB)、肌钙蛋白I(TnI)和肌红蛋白(MYO)的水平在3组间差异均无统计学意义(P>0．05)。 AHCM组、NOHCM组和OHCM组心电图上深尖倒置T波(GNT)出现的频率分别为57.7%、12.8%和8.0%( P<0.01),且AH-CM组多伴有左心室高电压。结论 AHCM与典型OHCM的临床特点差异明显,而与典型的NOHCM差异不大心脏超声检查阳性及心电图胸导联上典型的GNT可为确诊AHCM提供依据。
목적：통과여전형적비후형심기병( HCM)비교,탐토심첨비후형심기병( AHCM)적림상급심장초성특점。방법회고성수집90례HCM주원환자적림상자료,분성3조진행비교。 AHCM조：AHCM 26례。전형HCM환자(실간격이급좌심실벽비후),근거시부존재류출도경조분성이조,즉비경조성비후형심기병( NOHCM)조39례；경조성비후형심기병( OHCM)조25례。비교삼조환자적림상증상、심장초성특점。결과 AHCM조환자적발병년령교OHCM조만[(48.9±12.6)세VS.(38.5±12.0)세,P<0.01],무졸사가족사,림상증상경,교소출현로력성호흡곤난,혈장심기매중기산격매동공매(CK-MB)、기개단백I(TnI)화기홍단백(MYO)적수평재3조간차이균무통계학의의(P>0．05)。 AHCM조、NOHCM조화OHCM조심전도상심첨도치T파(GNT)출현적빈솔분별위57.7%、12.8%화8.0%( P<0.01),차AH-CM조다반유좌심실고전압。결론 AHCM여전형OHCM적림상특점차이명현,이여전형적NOHCM차이불대심장초성검사양성급심전도흉도련상전형적GNT가위학진AHCM제공의거。
Objective To analyze the clinical and echocardiographic features in patients with apical hypertrophic Cardio-myopathy(AHCM)and typical hypertrophic Cardiomyopathy(HCM). Methods This retrospective analysis included 90 patients hospitalized in our hospital. Patients were divided into three groups: apical hypertrophic Cardiomyopathy(AHCM,n=26)group, non-obstructive typical hypertrophic Cardiomyopathy ( NOHCM, n = 39 ) and obstructive typical hypertrophic Cardiomyopathy (OHCM, n=25). Clinical and echocardiographic features. Results The age at disease onset was older in AHCM group than in OHCMgroup[(48.9±12.6)yearsvs.(38.5±12.0)years,P<0.01].PlasmaCK-MB,TPIandMYOlevelsweresimilara-mong the Three groups. The frequency of giant negative T waveson ECG was 57. 7%、12. 8% and 8. 0%(P<0. 01)in AHCM, NOHCM and OHCM respectively. Half of AHCM patients showed left ventricular high voltage on ECC. Conclusion AHCM pa-tients differ from typical OHCM patients in clinical characteristics. There were significant differences on echocardiography and elec-trocardiography features among three groups. Echocardiography and giant negative T waves on ECC are helpful for the diagnosis of AHCM.