肥厚型心肌病的临床分型与分析

目的 对肥厚型心肌病的临床，心电图、超声心动图等资料进行分析。提高对复杂病例的诊断与鉴别诊断水平。方法 利用超声心动图，结合磁共振等特殊检查。对48例病人进行分型和分析。结果 按血流动力学特征，可分为梗阻型10例（均为左心室），非梗阻型38例；按肥厚部位则可分为右心室肥厚型1例，双室肥厚型2例，左心室肥厚型45例，其中乳头肌肥厚1例，肥厚扩张型3例。心尖肥厚14例，室间隔或/和侧壁肥厚27例。结论 肥厚型心肌病可因其血流动力学或病理解剖学特征的不同而表现迥异；正确诊断有赖于对病史，临床表现，心电图，超声心动图及其他特殊检查资料的综合分析和判断。

The analysis and clinical subtype of hypertrophic cardiomyopathy

Objectives Analyzing of the clinical materials, electrocardiogram, echocardiography and the other special examining materials of 48 patients, to improve the diagnosis and differential diagnosis for the complicate cases. Methods Making use of echocardiography, combining with electrocardiogram, magnetic resonance imaging, ventricular cardiograph and endomyocardial biopsy, to set up a classification of the clinical subtype. Results According to the features in hemodyna mics , the patients could be divided as 10 cases of the obstructive type and 38 cases of the non-obstructive; according to the position of hypertrophy, the patients could be divided as one of the right ventricular hypertrophic type, 2 cases of the dual ventricular and 45 cases of the left. Among with the rest, there were one case of the papillary muscular hypertrophy, 3 cases of dilated phase of HCM, 14 cases of the apical and 27 cases of the lateral and/or the interval. Conclusions Hypertrophic cardiomyopathy can appear the different manifestations as the different hymodynamic or pathologic feature; the corrective diagnosis depends on the comprehensive analysis and judgment to the patients' materials with their history, clinical features, electrocardiogram, echocardiography and the special examination.