肥厚型心肌病患者临床症状及超声心动图特点

Clinical and echocardiograghic characteristics of hypertrophic cardiomyopathy

目的 总结肥厚型心肌病患者临床症状及超声心动图特点 ,探讨二者之间的关系。方法 收集 10 3例肥厚型心肌病患者的病史、体征、心电图和超声心动图结果并进行统计学分析。结果 1、肥厚型心肌病患者的症状以劳力性呼吸困难为多见 ,与舒张功能异常有关 (P<0 .0 5 ) ,2、心电图异常者占 93% ,3、超声心动图显示 :(1)非对称型肥厚 74 % ,对称型肥厚 2 6 % ,心尖肥厚型 4例 ;(2 )非梗阻型 72 % ,梗阻型 2 8% ;(3)全部病例左心室射血分数均正常 ,舒张功能受损占 5 0 % ;(4 )梗阻组左心室腔明显缩小 ,室间隔明显增厚 ,有二尖瓣前叶收缩期前向运动 (SAM)现象者占 6 6 % ,与非梗阻组比较有显著性差异 (P<0 .0 5 )。结论 肥厚型心肌病临床症状、心电图表现无特异性 ,结合超声心动图可确诊 ;左心室流出道梗阻的发生与室间隔肥厚的程度有关 ;

Objective To analyze the characteristics of clinical Aymptom and echocardiogram in patients with hypertrophic cardiomyopathy(HCM).Methods 103 patients were evaluated on their illness history ,symptom, ECG and echocardiographic features. Result ①Main symptom: Effort dyspnea; ②ECG: Abnormal Q wave,ST segment depression and T wave inversion; ③echocardiogram: IVS hypertrophy, asymmetric and non-obstructive hypertrophy were predominant. SAM observed in 29% patients. All patients were with normal systolic function, but 50% patients with diastolic dysfunction, which evaluated by E/A ratio of mitral flow; ④Effort dyspnea was correlated with diastolic dysfunction. Conclusion HCM could be suspected by the indication of illness history and ECG, echocardiogram was a reliable diagnostic approach. Effort dyspnea as the main symptom correlated with diastolic dysfunction.