肥厚梗阻型与非梗阻型心肌病的临床特点和预后分析

Clinical features and prognosis of obstructive and non-obstructive hypertrophic cardiomyopathy patients

目的:对比分析肥厚梗阻型与非梗阻型心肌病临床特点及预后。方法:选择2003-2006年入院的肥厚性心肌病患者112例,其中肥厚梗阻型心肌病54例,非梗阻型58例,对比分析其临床资料并平均追踪随访(4.5±2.8)年。结果:肥厚梗阻型与非梗阻型心肌病病人在年龄、家族史、合并症等方面差别无统计学意义,梗阻型患者中女性的比例明显高于非梗阻型。梗阻型患者胸闷、心脏杂音等表现较为多见,其他症状、体征及临床转归在梗阻型和非梗阻型患者之间差异无统计学意义。二尖瓣前叶收缩期前移(SAM征)、左心室流出道最大压差(LVOT)、左室射血分数(LVEF)、左房内径、二尖瓣返流等方面肥厚梗阻型心肌病与非梗阻型差异有统计学意义。随访期间临床事件发生率低,且两组之间差别无统计学意义。结论:肥厚梗阻型与非梗阻型心肌病病人在年龄、家族史、合并症等方面差别不显著。通过积极、以β阻滞剂为主的药物治疗,临床事件及心脏事件发生率低。

AIM： To compare and analyse the clinical features and outcomes between obstructive and non-obstructive hypertrophic cardiomyopathy （HCM）. METHODS： We made a retrospective analysis of the clinical data of 112 patients （54 patients were obstructive HCM and 58 patients were non-obstructive HCM） ） admitted in our hospital from 2003 to 2006 with the diagnosis of HCM, and followed up for （4.5 ＋ 2.8 ） years. RESULTS： There were no significant differences in age, family history and complications between obstructive and non-obstructive HCM patients. The proportion of female patients was markedly higher in the obstructive HCM patients than that in the non-obstructive HCM patients. Besides chest distress and heart murmur were more obvious in the obstructive HCM patients, there was no significant difference between the two groups as to other clinical symptoms, signs and clinical outcome. The differences in systolic anterior motion of the mitral valve（SAM sign）, maximum pressure gradient in the left ventricular outflow tract （LVOT）, left ventricular ejection fraction（LVEF）, left atrial diameter, mitral valve regurgitation reached sinificance between the obstructive HCM group and the non-obstructive HCM group. The incidence of clinical events was low in follow-up period, and there was no difference between the two groups. CONCLUSION： There were no significant differences in age, family history and, complications between obstructive and non-obstructive HCM patients. Alter t3 blocker-based drug treatment, the incidence of clinical and cardiac events were relatively lOW.