CAJ | 학술논문

左心室中部肥厚型梗阻性心肌病的临床特点及预后
좌심실중부비후형경조성심기병적림상특점급예후
Clinical Characteristics and Prognosis in Patients With Mid-ventricular Obstructive Hypertrophic Cardiomyopathy

万方数据

中国循环杂志中國循環雜誌 중국순배잡지
Chinese Circulation Journal
2015年 11期 1053-1057 ,共5页

安硕研%樊朝美%赵世华%田月琴%刘延玲%段福建%王志民%王红月%蔡迟%闫丽荣%郭曦滢%杨尹鉴%李一石

안석연%번조미%조세화%전월금%류연령%단복건%왕지민%왕홍월%채지%염려영%곽희형%양윤감%리일석

左心室中部%肥厚%梗阻%心尖室壁瘤左心室中部%肥厚%梗阻%心尖室壁瘤
좌심실중부%비후%경조%심첨실벽류
Mid-ventricular%Hypertrophy%Obstruction%Apical aneurysm

目的：本研究旨在探究左心室中部肥厚型梗阻性心肌病（MVOHCM）患者的临床特点及长期预后。 　　方法：对66例MVOHCM患者的发病率、临床特征、心血管事件发生率和死亡率进行了回顾性分析。根据Kaplan-Meier法计算累积生存率。使用单因素和多因素Cox风险模型计算心原性死亡和心血管事件的危险因素及95%可信区间。 　　结果：66例MVOHCM患者在2413例肥厚型心肌病（HCM）患者中约占2.74%。平均诊断年龄为（40.16±14.64）岁。经过平均（7.30±6.25）年的随访，MVOHCM患者的心血管死亡率为13.64%，不明原因晕厥[风险比（HR）：13.37，95%可信区间（CI）：1.65~114.46，P=0.015]是心血管死亡的独立预测因子。30例（45.45%）患者至少发生了一次心血管事件，其中最常见的是非持续性室性心动过速（NSVT）。13例（19.70%）患者合并心尖室壁瘤，此类患者更易发生NSVT。 　　结论：MVOHCM预后不良。心血管事件发生率高，部分患者合并心尖室壁瘤形成。早期诊断对MVOHCM患者的合理治疗十分必要。
목적：본연구지재탐구좌심실중부비후형경조성심기병（MVOHCM）환자적림상특점급장기예후。 　　방법：대66례MVOHCM환자적발병솔、림상특정、심혈관사건발생솔화사망솔진행료회고성분석。근거Kaplan-Meier법계산루적생존솔。사용단인소화다인소Cox풍험모형계산심원성사망화심혈관사건적위험인소급95%가신구간。 　　결과：66례MVOHCM환자재2413례비후형심기병（HCM）환자중약점2.74%。평균진단년령위（40.16±14.64）세。경과평균（7.30±6.25）년적수방，MVOHCM환자적심혈관사망솔위13.64%，불명원인훈궐[풍험비（HR）：13.37，95%가신구간（CI）：1.65~114.46，P=0.015]시심혈관사망적독립예측인자。30례（45.45%）환자지소발생료일차심혈관사건，기중최상견적시비지속성실성심동과속（NSVT）。13례（19.70%）환자합병심첨실벽류，차류환자경역발생NSVT。 　　결론：MVOHCM예후불량。심혈관사건발생솔고，부분환자합병심첨실벽류형성。조기진단대MVOHCM환자적합리치료십분필요。
Objective: To describe the clinical characteristics with long-term prognosis in patients with mid-ventricular obstructive hypertrophic cardiomyopathy (MVOHCM). Methods: A total of 66 MVOHCM patients treated in our hospital were retrospectively studied for their morbidity, clinical characteristics and mortality. The cumulative survival rate was calculated by Kaplan-Meier method; the risk factors for cardiac death and cardiovascular events were analyzed by uni- and multivariate Cox proportional hazard model. Results: There were 66 (2.74%) patients suffering from MVOHCM among 2413 patients of hypertrophic cardiomyopathy and the average diagnostic age was (40.16 ± 14.64) years. With (7.30 ± 6.25) years of follow-up study, the cardiovascular mortality was 13.6% and unexplained syncope (HR=13.37, 95% CI: 1.65-114.46, P=0.015) was the independent predictor for cardiovascular death. There were 45.45% (30/66) patients experienced at least 1 time of cardiovascular event and the most frequent one was non-sustained ventricular tachycardia (NSVT); 19.70% (13/66) of patients combined with apical aneurysms, and they were more inclined to experience NSVT. Conclusion: MVOHCM patients usually have unfavorable prognosis with the higher incidence of cardiovascular events, some patients may develop apical aneurysm. The early diagnosis of MVOHCM is important for appropriate treatment.