Characteristics of patients with hypertrophic cardiomyopathy expansion phase of research and living conditions
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摘要: 目的:探讨肥厚型心肌病(hypertrophic cardiomyopathy,HCM)患者扩张相的特征与生存状况。方法:选取2008-04-2011-08我院收治的HCM患者496例,依据诊断结果分为扩张相组(18例)和对照组(478例),比较2组患者的临床特征和1年、3年、5年生存率,并进行COX回归分析。结果:扩张相组患者的心房颤动(房颤)、猝死、NYHA分级Ⅲ~Ⅳ级、束支传导阻滞比例明显高于对照组,左心室舒张末期内径(LVEDD)、左房最大容积(LAVmax)、左房前后径(LAD)、左室壁厚度(LVWH)水平显著高于对照组,左室射血分数(LVEF)明显低于对照组,以上差异均有统计学意义(P＜0.05)。扩张相组1年、3年、5年生存率分别为94.44%、77.78%、61.11%;对照组1年、3年、5年生存率分别为97.07%、93.93%、89.96%。随访结束时,扩张相组2例患者进展为扩张期,7例死亡[2例死于心力衰竭(心衰),5例猝死];对照组中21例进展为扩张期,48例患者死亡(10例死于心衰,38例猝死)。房颤、猝死、NYHA分级Ⅲ~Ⅳ级、LVEF＜50%是影响HCM患者扩张相生存状况的独立危险因素(P＜0.05)。结论:HCM患者扩张相的主要临床特征为房颤,猝死,NYHA分级Ⅲ~Ⅳ级,束支传导阻滞,LVEDD、LAVmax、LAD、LVWH升高和LVEF降低,患者长期生存状况不佳,其中房颤、猝死、NYHA分级Ⅲ~Ⅳ级、LVEF＜50%是影响患者生存状况的独立危险因素。Abstract: Objective:To explore the characteristics and survival of patients with hypertrophic cardiomyopathy.Method:Selected 496 patients with hypertrophic cardiomyopathy from April 2008 to August 2011 in our hospital. Those patients were divided into the expansion phase group (n=18) and control group(n=478) , according to the diagnosis. We compared two group's i patie clinical characteristics and 1-year, 3-year, 5-year survival rate, and analyzed usingand COX regression.Result: The expansion phase group of patients with atrial fibrillation, sudden death, NYHA grade Ⅲ~Ⅳ grade, bundle branch block, LVEDD, LAVmax, LAD, LVWH was significantly higher than those of control group, but LVEF was significantly lower. The above differences were statistically significant (P＜0.05). In expansion phase group, 1-year, 3-year, 5-year survival rates were 94.44%, 77.78%, 61.11%, respectively; while in control group, 1-year, 3-year, 5-year survival rates were 97.07 percent, 93.93 percent, 89.96%, respectively. At the end of the follow-up, there were 2 cases developed to expansion period, 7 patients died, 2 cases died of heart failure, 5 cases of sudden death in the expansion phase group; 21 cases developed to expansion period, 48 patients died, 10 cases died of heart failure, 38 cases of sudden death in control group. Atrial fibrillation, sudden death, NYHA grade Ⅲ~Ⅳ class, LVEF＜50% were independent risk factors in the expansion phase group (P＜0.05). Conclusion:The major clinical feature in expansion phase group of patients with hypertrophic cardiomyopathy is the atrial fibrillation and sudden death, NYHA grade Ⅲ~Ⅳ, bundle branch block, LVEDD, LAVmax,LAD, LVWH increased and LVEF decreased. Atrial fibrillation ,sudden death, NYHA grade Ⅲ~Ⅳ, LVEF ＜50% are independent risk factors.
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Key words:
- hypertrophic cardiomyopathy /
- expansion phase /
- clinical features /
- living conditions
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