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目的:探讨中国肥厚型心肌病(HCM)患者的临床表现及住院转归。方法:回顾性分析234例HCM患者的临床资料。结果:全部患者男158例、女76例,发病年龄女性高于男性(P<0.05),女性心房颤动发生率高于男性(32.9%∶14.6%,P<0.05)。绝大多数患者(93.6%)临床症状为胸闷、胸痛、心悸等,无特异性,仅15例(6.4%)患者无临床症状,体检时诊断该病;绝大多数患者(93.6%)ECG表现为非特异性ST-T改变,肥厚累及心尖部者胸前导联见巨大倒置T波,仅15例(6.4%)患者ECG无异常;超声心动图示,梗阻性HCM者30例(13.0%),心尖HCM 57例(24.9%),男∶女=3.4∶1,肥厚累及右心室6例,心室壁平均厚度为(19.5±4.6)mm。冠状动脉造影有>75%的狭窄者16例(15.5%)。接受β-受体阻滞剂和(或)非二氢吡啶类钙离子拮抗剂(CCB)治疗者194例(82.9%),起搏器置入者18例,经皮化学消融者6例,左心室流出道疏通术5例。院内发生猝死事件者5例,其中3例患者经电复率或药物复率后存活,2例抢救无效死亡。结论:中国HCM的发病年龄较国外偏大,临床表现无特异性;女性比男性发病年龄偏大,且更易发生心房颤动;心尖HCM约占1/4,男性多于女性;绝大多数患者以药物治疗为主,住院转归良好。
Objective: To investigate the clinical manifestations and hospitalization of patients with hypertrophic cardiomyopathy (HCM) in China. Methods: A retrospective analysis of 234 cases of HCM clinical data. Results: There were 158 males and 76 females in all patients. The incidence of atrial fibrillation was higher in females than in males (32.9% vs 14.6%, P <0.05). In the vast majority of patients (93.6%), the clinical symptoms were chest tightness, chest pain, palpitations, etc. There were no specific symptoms. Only 15 patients (6.4%) had no clinical symptoms and were diagnosed at the time of examination. The vast majority of patients (93.6% In non-specific ST-T changes, patients with hypertrophic involvement of the apex showed a large inverted T wave, and ECG was abnormal in only 15 patients (6.4%). Echocardiography showed that 30 patients (13.0%) had obstructive HCM, 57 (24.9%) apicom HCM, male: female = 3.4:1, hypertrophy involving the right ventricle in 6 cases, the average thickness of the ventricular wall was (19.5 ± 4.6) mm. Coronary angiography> 75% of the stenosis in 16 cases (15.5%). Ninety-four patients (82.9%) were treated with β-blockers and / or non-dihydropyridine calcium antagonists (CCB), 18 with pacemaker implants, 6 with percutaneous chemical ablation, Left ventricular outflow tract dredging in 5 cases. There were 5 cases of sudden death in the hospital, of which 3 patients survived by electrical or drug reuptake and 2 died without rescue. Conclusions: The age of onset of HCM in China is larger than that in other countries, and the clinical manifestations are nonspecific. Women are older than men and are more likely to develop atrial fibrillation. Apex HCM accounts for about 1/4 and men more than women. Most patients Drug treatment, good hospital stay.