老年扩张型心肌病的临床特点分析

Clinical characters of dilated cardiomyopathy in elderly patients

目的探讨老年人扩张型心肌病(DCM)的临床特征。方法对1988年至2004年间入院的51例老年和56例非老年DCM患者的临床资料进行回顾性分析。结果老年组合并肺部感染、慢性肾功能不全较非老年组多见(P<0.05);老年组确诊时心功能分级达Ⅲ或Ⅳ级(NYHA)者多见(86.3%与50%,P=0.002<0.01);老年组左房内径(53.5±5.5)mm,心房纤颤者22例(43.1%),二度及三度房室传导阻滞7例(13.7%),而非老年组左房内径(46.4±5.7)mm、心房纤颤者14例(25%),且未发现二度及三度房室传导阻滞,两组相比差异有统计学意义(均P<0.05);老年组随访24例,死亡8例,死亡原因为充血性心力衰竭者5例(62.5%);非老年组随访16例,死亡7例,死亡原因为充血性心力衰竭者4例(57.1%)。结论老年人DCM确诊时大多已呈中、重度心力衰竭,易出现合并症,主要死因为心力衰竭。

Objective To study the clinical characteristics in elderly patients with dilated cardiomyopathy （DCM）. Method The clinical data of dilated cardiomyopathy in 51 elderly and 56 non-elderly cases were analyzed retrospectively. Results Pulmonary infection ,chronic renal insufficiency in elderly patients were significantly more common than in non-elderly group（ P 〈 0.05 ） ;40/51 elderly patients（ 86.3% ） were NYHA function Ⅲ-Ⅳ ,28/56 （50%） in the non-elderly patients. Atrial fibrillation（43.1% ）, Ⅱ°or Ⅲ°A-V block（ 13.7% ） were significantly more common in the elderly than the non-elderly patients （ P 〈 0.05 ）. 8 patients of 24 elderly died, during the follow - up the main cause of death （ 62.5% ） was congestive heart failure in the elderly. Conclusion Most elderly patients manifested moderated and severe heart failure when DCM was diagnosed. The major cause of death of DCM is congestive heart failure.