心尖肥厚型心肌病合并冠心病的临床特点分析

Apical Hypertrophic Cardiomyopathy Complicated by Coronary Heart Disease:Clinical Features

目的:探讨心尖肥厚型心肌病(AHCM)合并冠心病的临床特点。方法:将25例经冠状动脉造影检查的AHCM患者分为冠状动脉异常组(A组)6例及冠状动脉正常组(B组)19例,对两组临床特点、心电图、超声心动图进行对比分析。结果:平均年龄A组(63.7±13.7)岁,B组(51.7±9.8)岁,统计学比较具有显著性差异(P<0.05)。有≥1个心血管危险因素者,A组4例,B组1例,A组明显高于B组(P<0.05)。两组心电图比较,左室高电压、T波倒置深度以及ST段平均下移幅度均无统计学差异(P>0.05),出现异常Q波,A组2例,B组1例。两组超声心动图比较,心肌肥厚程度、左室内径、左室容积以及左室收缩和舒张功能指标均无显著性差异(P>0.05)。结论:老年AHCM患者存在高脂血症、肥胖、糖尿病、吸烟等危险因素,则可能合并冠心病。

Objective:To explore the clinical features of apical hypertrophic cardiomyopathy (AHCM) combined with coronary artery disease (CAD).Methods:25 patients with AHCM confirmed by angiography were defined as 6 cases with abnormal coronary artery (A group) and 19 cases having normal coronary artery (B group).A case-control study design was employed to compare the features of echocardiography, clinical findings and electrocardiography between the two groups.Results:The mean age of the Group A was 63.7±13.7 years while it was 51.7±9.8 years in Group B.They were significantly different (P<0.05).4 patients in Group A were having at least one or over risk factors for cardiovascular events whereas only one subject in Group B was processing the equivalent number of the risk factors with a significant difference between the two groups (P<0.05).There were no significant differences in ECG and UCG characters between two groups,nor in the clinical manifestations,but the differences in age and whether having CHD risk factors were significant between two groups (P>0.05).Conclusions:Elder AHCM patients with typical angina and coronary heart disease risk factors such as hyperlipidemia,obesity diabetes and smoking,were more likely to suffer from AHCM combined with coronary artery disease.