CAJ | 학술논문

目的：分析成人心肌致密化不全患者的临床特征及其预后情况，以期提高对该病的认识。方法回顾性分析2008-03～2013-05该院收治的13例成人心肌致密化不全患者的临床资料。结果13例患者误诊为扩张型心肌病8例，冠心病3例，心脏瓣膜性病2例。超声心动图检查左房、左室受累12例，累及左、右房室1例，射血分数＜50％者9例，室壁运动弥漫性减低7例。12例患者合并不同类型心律失常，1例心电图未见明显异常。针对患者并发症给予控制心力衰竭，纠正心律失常发作等治疗，2例无症状者未予药物治疗。随访12～26个月，心力衰竭者左心室进行性扩大，1例合并主动脉瓣关闭不全者和1例心功能NY-HAⅣ级患者死亡，2例发生血栓事件。结论成人心肌致密化不全临床表现差异较大，应注重提高内科及超声科医师对该病的认识，减少漏、误诊发生，以利尽早积极对症治疗，改善患者预后。
목적：분석성인심기치밀화불전환자적림상특정급기예후정황，이기제고대해병적인식。방법회고성분석2008-03～2013-05해원수치적13례성인심기치밀화불전환자적림상자료。결과13례환자오진위확장형심기병8례，관심병3례，심장판막성병2례。초성심동도검사좌방、좌실수루12례，루급좌、우방실1례，사혈분수＜50％자9례，실벽운동미만성감저7례。12례환자합병불동류형심률실상，1례심전도미견명현이상。침대환자병발증급여공제심력쇠갈，규정심률실상발작등치료，2례무증상자미여약물치료。수방12～26개월，심력쇠갈자좌심실진행성확대，1례합병주동맥판관폐불전자화1례심공능NY-HAⅣ급환자사망，2례발생혈전사건。결론성인심기치밀화불전림상표현차이교대，응주중제고내과급초성과의사대해병적인식，감소루、오진발생，이리진조적겁대증치료，개선환자예후。
Objective To explore the clinical features and prognosis on the adult patients with noncompac -tion of ventricular myocardium ( NVM) .Methods The data of 13 adult patients with NVM from March 2008 to May 2013 were analyzed retrospectively .Results Among all patients , 8 patients were misdiagnosed as dilated cardiomy-opathy, 3 patients were misdiagnosed as coronary heart disease and 2 patients were misdiagnosed as heart valve dis-ease.Examined by echocardiography , 12 cases were found having left atrium and left ventricular dysfunction , 1 case having left and right atrioventricular dysfunction .Ejection fraction was less than 50% in 9 cases.Ventricular wall motion diffuse was decreased in 7 cases.12 cases suffered from different types of arrhythmia , while electrocardiogram retain normal in 1 case.Cardiac failure, arrhythmia and other complications were controlled when needed .2 patients with no symptoms didn′t take any medication .After a follow-up for 12 to 26 months, left ventricle was progressively amplified in all patients with cardiac failure , with aortic insufficiency in 1 case, thrombosis in 2 cases and cardiac function NYHAⅣin 1 case.Conclusion There are great differences of the clinical manifestations among the patients with NVM.Awareness of the disease should be raised in physicians and ultrasound doctors to recognize it better and to reduce missing diagnosis and to improve the patients′prognosis .