左室心肌致密化不全患者的临床特点及预后影响因素分析

Clinical characteristics and prognosis of patients with left ventricular non-compaction

目的:探讨左室心肌致密化不全(left ventricular non-compaction,LVNC)患者的临床特征和预后之间的关系及其影响因素。方法:回顾性分析61例LVNC患者的临床和随访资料,对患者的生存影响因素进行COX回归分析,生存时间采用Kaplan-Meier分析。结果:61例LVNC患者中,男41例,女20例;平均年龄(40.9±19.8)岁;平均随访时间(68.6±47.2)个月;全因死亡12例,病死率为19.7%。单因素COX回归分析显示年龄、吸烟史、饮酒史、室性心律失常、左房内径、左室内径、血肌酐和尿素氮水平与全因死亡相关;均衡相关因素后,多因素COX回归分析发现,左房内径和血肌酐水平为LVNC患者预后的预测因素。结论:LVNC患者的预后不佳,左房内径和血肌酐水平是LVNC患者预后的独立预测指标。

Objective：To study the clinical characteristics and prognosis of patients with left ventricular noncompaction（LVNC）.Method：Clinical data of 61 patients with LVNC admitted to our hospital were retrospectively analyzed.Risk factors of the all-cause mortality in patients with LVNC were analyzed with Cox regression models and Kaplan-Meier survival curves.Result：Among the 61 patients,41 patients were male and 20 patients were female.The mean age of the 61 patients were（40.9±19.8）years with the mean follow-up period of（68.6±47.2）months.12 patients died with all-cause mortality of 19.7% during the follow-up.The Cox univariate analysis showed that age,history of smoking,history of drinking,ventricular arrhythmia,left atrial diameter（LAD）,left ventricular diameter（LVD）,circulating creatinine（CR）level and urea nitrogen level（BUN）at admission contributed to increase risk of all-cause mortality.Cox multivariate analysis showed that LAD〉40 mm and circulating CR〉98μmol/L were independent predictors of all-cause mortality in patients with LVNC.Conclusion：The prognosis of patients with LVNC was poor.It is of great importance to pay attention to the prognosis and care of such patients with LAD more than 40 mm or circulating CR level more than 98.0μmol/L.