肥厚性心肌病42例临床分析

目的观察原发性肥厚性心肌病(HCM)的临床特点。方法对42例肥厚性心肌病的临床特点、心电图、超声心动图进行回顾分析。结果该病的临床表现无特异性,多数伴有临床症状;心电图的改变多种多样,以ST-T改变多见,超声心动图的改变具有诊断价值。42例HCM患者室间隔舒张末期厚度IVSTd为(18.33±3.8)mm,左室后壁舒张末期厚度LVPWTd为(10.77±2.95)mm,IVSTd/LVPWTd比值为1.74±0.5,左心室舒张末期内径LVIDd为(45.06±5.85)mm。梗阻性和非梗阻性HCM两组病人的左室射血分数LVEF%正常,但组间比较无统计学意义(P>0.05)。左室后壁收缩期增厚率(LVPW△T%)均值较室间隔收缩期增厚率(IVS△T%)均值为大,梗阻性IVS△T%较非梗阻性更小(P<0.05),梗阻性组IVSTd、IVSTd/LVPWTd比值、二尖瓣A波峰值与非梗阻性相比更大(P<0.05)。E/A比值在梗阻性肥厚性心肌病<1,而在非梗阻性肥厚性心肌病则>1,但组间无统计学意义(P>0.05)。结论超声心动图能很好地识别HCM室壁异常增厚的特征,并能评价心室的收缩和舒张功能,结合临床、心电图以及超声心动图可以对HCM作出准确诊断。

Clinical Analysis of 42 Cases with Hypertrophic Cardiomyopathy

Objective To observe the clinical features of the primary hypertrophic cardiomyopathy(HCM) .Methods Retrospectively analyzing the clinical characteristics,electrocardiogram,echocardiography of HCM.Results HCM has non-specific clinical manifestations with most accompanied by clinical symptoms;ECG changes variously with ST-T changes seen more common;Echocardiography has a diagnostic value.42 HCM patients:IVSTd(18.33 ± 3.8) mm,LVPWTd(10.77 ± 2.95) mm,IVSTd / LVPWTd(1.74 ± 0.5),LVIDd(45.06 ± 5.85) mm.LVEF% was normal in obstructive and non-obstructive HCM groups,but the comparison had no statistical significance between the two groups(P >0.05).Mean LVPW △T% was more than IVS △T%,but obstructive IVS △T% was smaller than that of non-obstructive(P <0.05).IVSTd,IVSTd / LVPWTd,A-wave peak in obstructive group was much more than those in non-obstructive group(P <0.05).E/A was <1 in obstructive group,>1 in non-obstructive group,but there was no statistical significance between the two groups(P >0.05).Conclusions Echocardiography can well identify abnormal thickening of HCM,and can evaluate ventricular systolic and diastolic function.Combination of clinical,ECG,and UCG can make accurate diagnosis of HCM.