老年前期及老年期肥厚型心肌病——(附73例临床分析)

Diagnosis and Treatment of Preaged and Aged Hypertrophic Myocardiopathy, Clinicl Analysis of 73 Cases

本文分析50岁以上老年人肥厚型心肌病73例,全部病例经超声心动图确诊。男52、女21例。年龄60岁以下30例,60岁以上43例,其中70岁以上11例。非梗阻型23例、梗阻型50例。本组有4个家族,为特发性肥厚型心肌病。合并高血压者47例(64％),经心动图证实有室壁节段性运动障碍诊为冠心病者19例,其中经酶学和心电图动态改变确诊为急性心梗者7例。合并老年退行性瓣膜病变27例。此外,对老年肥厚型心肌病的临床特点、病因、诊断、鉴别诊断、治疗和预后等问题进行了分析和讨论:1.老年期及老年前期肥厚型心肌病并不少见。2.发病除遗传因素外可受多种后天因素影响。3.常合并高血压、冠心病和退行性瓣膜病。4.钙拮抗剂治疗可获良好效果,但如临床必须用血管扩张药时,仍可在严密观察下使用。5.预后相对良好。

Seventy-three patients, 52 men and 21 women, with hypertrophic cardiomyopathy(HCM), diagnosed by echocardiogram were reported. They were of the age of 50-59years in 30 cases, 60-69 years in 32, over 70 years in 11. 50 cases were obstructive and23 cases were nonobstructive. There were hypertension in 47 cases (64%), coronaryheart disease confirmed with segmental motion in ventricular wall by echocardiogramin 19 cases, acute myocardial infarction diagnosed by myocardial enzymology andECG in 7 cases, and degenerative valvular lesion in 27 cases. The etiology, diagnosisand complications were analysed and discussed. It was shown that: 1. The incidence of pre-aged and aged HCM was not very low. 2. As to the etiology of HCM, there might be several acquired factors in addi- tion to hereditary ones. 3. Hypertension, coronay heart disease, degenerative valvular lesion were common complicated diseases. 4. Treatment with calcium channel blockers usually had a favorable effect, but close attention should be paid when it had to be used with vasodilators. 5. The prognosis of HCM was relatively saticfactory in the elderly.