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近年来扩张型心肌病有增多趋势.本病初诊时易误诊为其他心脏病.本文对56例扩张型心肌病进行临床分析.并对其中36例误诊情况予以讨论.1 临床资料1.1 一般资料 本组56例均系住院病人.男38例.女18例、男;女2.1:1.年龄16～80(平均51.7)岁,其中<40岁14例,>60岁16例.1.2 诊断依据 ①每例均经UCG、X线检查发现心脏扩大;②临床排除了风湿性心脏病、冠心病、高血压性心脏病、先天性心脏病、心包积液等其他心脏病;③排除了原发性肥厚型心肌病及其继发性心肌病.1.3 临床表现 本组中24例以充血性心力衰竭力主要临床表现.14例以心律失常为主要临床表现.8例心力衰竭与心律失常二者并重.另10例分别以呼吸道症状、消化道症状及脑缺氧症状为主要临床表现.其中6例因缓慢性心律失常伴反复晕厥接受埋藏式永久起搏治疗.NYHA心功能分级Ⅱ级10例,Ⅲ级14例、Ⅳ级32例.56例中住院期死亡8例.其中3例猝死、另5例死于顽固性心力衰竭.1.4 心电图分析 本组56例入院EKG均有差异,其中36例有ST-T改变.发生率64.3%;16例显示左心
Dilated cardiomyopathy in recent years there is an increasing trend of the disease is often misdiagnosed as other heart disease in the first diagnosis of 56 cases of dilated cardiomyopathy clinical analysis and 36 cases of misdiagnosis to be discussed.1 Clinical data 1.1 General Information 56 patients were in-patient group, 38 males and 18 females, male and female 2.1: 1. The age ranged from 16 to 80 (average 51.7) years old, of which <40 years old in 14 cases and> 60 years old. Each case by UCG, X-ray examination found that the heart enlarged; ② clinically excluded rheumatic heart disease, coronary heart disease, hypertensive heart disease, congenital heart disease, pericardial effusion and other heart disease; ③ excluded the primary Hypertrophic cardiomyopathy and secondary cardiomyopathy.1.3 Clinical manifestations of the group of 24 cases of congestive heart failure main clinical manifestations of force .14 cases of arrhythmia as the main clinical manifestations.8 cases of both heart failure and arrhythmia both The other 10 cases were respiratory symptoms, gastrointestinal symptoms and cerebral hypoxia as the main clinical manifestations.Among them 6 cases of bradyarrhythmia with recurrent syncope by buried permanent pacing therapy.NYHA cardiac function grade Ⅱ grade in 10 cases, Ⅲ grade 14 cases, Ⅳ grade 32 cases, 56 cases were hospitalized Died in 8 cases, of which 3 cases of sudden death and the other 5 died of refractory heart failure.1.4 ECG analysis of the group of 56 cases were admitted to hospital EKG were different, including 36 cases of ST-T change in the incidence of 64.3%; 16 cases showed left heart