80例肥厚型心肌病的临床分型

The subtypes of hypertrophic cardiomyopathy in 80 cases

对经磁共振检查确诊的80例肥厚型心肌病（HCM）进行分析，全心肥厚型10例（12．50％），厚度为25．60±6．93mm。局限肥厚型70例（87.50％），平均厚度为22．98±5．64mm，其中室间隔肥厚型31例（38．75％），平均厚度为22．66±5．85mm;游离壁肥厚型20例（25．00％），20.65±4．07mm；心尖肥厚型11例（13．75％），28．27±5．90mm；室间隔并游离壁肥厚型6例（7．50％），22．33±3．14mm；心尖并游离壁肥厚型及乳头肌肥厚型各1例。合并流出道狭窄者29例，占36．25％。心电图T波倒置者60例，占75．95％（60／79），而S-T段下降者仅9例，占11．39％（9／79），与冠心病心电图变化规律不同。左室肥厚型以全心HCM多见（80．00％）；非室间隔肥厚型TV5倒置最多（50．00％），T波倒置最深者多出现在全心HCM，而不是心尖肥厚型。异常Q波在各型间的分布无显著性差异。

Eighty patients with hypertrophic cardiomyopathy diagnosed by MRI were analysed. The global ventricular hypertrophy in 10(12. 50%) cases,the thickness of 25. 60±6. 93 mm.The localized hypertrophy in 70(87. 50% )cases,22. 98±5. 64 mm ;of them the septal hypertrophy in 31 (38. 75 % )cases, 22. 66 ± 5. 85 mm ; the free wall hypertrophy in 20 (25.00% ), 20. 65 ± 4. 07 mm ; the apical hypertrophy in 11 (13. 75% ) cases, 28. 27 ±5. 90 mm ; the combination of septum with free wall hypertrophy in 6(7. 50% )cases,22. 33±3. 14mm;the combination of apex with free wall hypertrophy in 1 case and the papillary muscular hypertrophy in 1 case. 29 (36. 25% )patients associated with left ventricular outnow tract obstruction. There were T wave abnormality on electrocardiograms in 60 cases, which accuounted for 75. 9%, ST segment depression only in 9(11. 39% )patients. That is available to differentiate from coronary artery disease. The left ventricular hypertrophy on electrocardiograms was common in global ventricular hypertrophy (80. 00% );TV5 inversion was seen frequently in nonseptal hypertrophyi the deepest T wave inversion was much more found in global ventricular hypertrophy but in apical hypertrophyl the distribution of abnormal Q wave was seen no differently among various subtypes.