19例心肌淀粉样变性患者的临床特点及预后分析

方位; 颜超; 林艳; 罗蓉; 李小平

doi:10.13201/j.issn.1001-1439.2017.02.004

19例心肌淀粉样变性患者的临床特点及预后分析

- 1 电子科技大学附属四川省人民医院心内科(成都, 610072);
- 2 成都医学院体温与炎症四川省高校重点实验室
基金项目:
国家自然科学基金(No:81470521)

四川省卫计委课题(No:150224)

详细信息

通讯作者: 李小平,E-mail:lixiaoping0119@163.com

中图分类号: R542.2

收稿日期: 2016-07-26

修回日期: 2016-11-30

Clinical characteristic and prognostic analysis of 19 patients with cardiac amyloidosis

- 1 Department of Cardiology, Sichuan Provincial People's Hospital, Hospital of the University of Electronic Science and Technology of China, Chengdu, 610072, China;
- 2 Temperature and Inflammation Research Center, Key Laboratory of Colleges and Universities in Sichuan Province, Chengdu Medical College

More Information

Corresponding author: LI Xiaoping, E-mail: lixiaoping0119@163.com

Received Date: 26 July 2016

Revised Date: 30 November 2016

摘要

摘要: 目的:探讨心肌淀粉样变性(CA)患者的临床特征和预后。方法:回顾性分析19例CA患者的临床资料,对患者的生存影响因素进行相关性和Cox回归分析。结果: 19例患者均出现心功能不全表现;肢体导联低电压10例;心脏核磁共振显像心肌呈不同程度延迟强化11例;就诊前有晕厥病史3例;19例患者中死亡9例,平均随访时间(24.2±4.5)个月,1年生存率为67.7%,2年生存率为56.4%,中位生存期为25.1个月。相关性分析表明,患者生存时间与入院时氨基末端B型脑钠肽前体(NT-proBNP)水平、晕厥病史之间存在负相关(r=-0.635,P=0.013;r=-0.632,P=0.002);单因素Cox回归分析,入院时NT-proBNP水平为CA预后的预测指标(P＜0.05)。结论:CA预后不佳,生存时间与入院时NT-proBNP水平、晕厥病史密切相关,入院时NT-proBNP水平是CA患者预后的预测指标。
- 心肌病 /
- 心肌淀粉样变性 /
- 预后
Abstract: Objective:To study the clinical characteristics and prognosis of patients with cardiac amyloidosis(CA).Method:Clinical data of 19 patients with CA admitted to our hospital were retrospectively analyzed. Risk factors of the survival in patients with CA were analyzed with correlation and Cox regression model. Result:All of the 19 patients showed cardiac dysfunction. Low voltage in limb leads were observed in 10 patients. CMR revealed different patterns of abnormal late gadolinium enhancement in 11 patients. Syncope occurred before hospitalization in 3 patients. In the present study, the mean follow-up period were (24.2±4.5)months, during which 9 patients died.One-year survival rate was 67.7%, two-year was 56.4% and the median survival time were 25.1 months. Survival time was negatively correlated with the circulating level of N terminal pro-brain natriuretic peptide(NT-proBNP) at admission and with the history of syncope(r=-0.635,P=0.013;r=-0.632, P=0.002).Cox regression analysis showed that the circulating level of NT-proBNP at admission was a predictive index for the prognosis of patients with CA(P＜0.05). Conclusion:The prognosis of patients with CA was poor and survival time was negatively correlated with the level of NT-proBNP at admission and the history of syncope. The level of NT-proBNP at admission was a predictive index for the prognosis of patients with CA.
- cardiomyopathies /
- cardiac amyloidosis /
- prognosis

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