应激性心肌病临床特点及预后研究

Clinical Characteristics and Prognosis of Stress Cardiomyopathy

目的探讨应激性心肌病临床特点及预后。方法回顾性分析我院2018年7月至2019年7月收治的50例应激性心肌病患者作为研究组,选择同期50例心肌梗死的患者作为对照组,对比两组相关临床特点。结果急性心肌梗死组50例患者均出现异常改变,ST段抬高异常、T波异常、病理性Q波、QT间期延长均高于应激性心肌病组(P<0.05),但总异常数和应激性心肌病组无差异(P>0.05)。急性心肌梗死组50例患者均出现异常,其中左前降支狭窄32例(64.00%),左回旋支狭窄23例(46.00%),右冠状动脉狭窄11例(22.00%)。应激性心肌病组患者44例(88.00%)无异常,6例(12.00%)为轻度冠脉狭窄。急性心肌梗死组死亡3例(6.00%),应激性心肌病组无死亡病例。结论应激性心肌病虽然与心肌梗死存在一定的相似性,但具有自身的特点,心理应激因素是发病的重要诱发因素,临床诊断上需要在考虑心电图的基础上借助超声心动图、冠脉造影早期明确,该病治疗效果较为明显,预后良好。

Objective To exlpore clinical characteristics and prognosis of stress cardiomyopathy.Methods Review and analyzed 50 cases stress cardiomyopathy patients admitted to our hospital from July 2018 to July 2019 as study group,and 50 cases myocardial infarction patients during the same period as control group.Compared clinical characteristics of two groups.Results All 50 cases in AMI group had abnormal changes,abnormal ST segment elevation,abnormal T wave,pathological Q wave and QT interval prolongation in AMI group was higher than stress cardiomyopathy group (P<0.05),there was no difference in total variation constant and stress cardiomyopathy group (P>0.05).In acute myocardial infarction group,there were 50 abnormal cases,including 32 cases of left anterior descending artery stenosis (64.00%),23 cases of left circumflex artery stenosis (46.00%),and 11 cases of right coronary artery stenosis (22.00%).In stress cardiomyopathy group,44 cases (88.00%) were normal,6 cases (12.00%) were mild coronary stenosis,3 cases (6.00%) died in acute myocardial infarction group and no death in stress cardiomyopathy group.Conclusion Stress cardiomyopathy is similar to myocardial infarction,it has its own characteristics.Psychological stress factor is an important inducing factor of the disease.Clinical diagnosis should be based on consideration of ECG,echocardiography and coronary angiography,which can achieve good treatment effect and prognosis.