80例肥厚型心肌病的临床分型  

The subtypes of hypertrophic cardiomyopathy in 80 cases

作　　者：程显声[1] 程晓荷[1] 李坤成[1] 李清[1] 马秀平[1,2] 

机构地区：[1]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院,北京100037 [2]北京首都医科大学宣武医院

出　　处：《临床心血管病杂志》1998年第3期131-133,共3页Journal of Clinical Cardiology

摘　　要：对经磁共振检查确诊的80例肥厚型心肌病（HCM）进行分析，全心肥厚型10例（12．50％），厚度为25．60±6．93mm。局限肥厚型70例（87.50％），平均厚度为22．98±5．64mm，其中室间隔肥厚型31例（38．75％），平均厚度为22．66±5．85mm;游离壁肥厚型20例（25．00％），20.65±4．07mm；心尖肥厚型11例（13．75％），28．27±5．90mm；室间隔并游离壁肥厚型6例（7．50％），22．33±3．14mm；心尖并游离壁肥厚型及乳头肌肥厚型各1例。合并流出道狭窄者29例，占36．25％。心电图T波倒置者60例，占75．95％（60／79），而S-T段下降者仅9例，占11．39％（9／79），与冠心病心电图变化规律不同。左室肥厚型以全心HCM多见（80．00％）；非室间隔肥厚型TV5倒置最多（50．00％），T波倒置最深者多出现在全心HCM，而不是心尖肥厚型。异常Q波在各型间的分布无显著性差异。Eighty patients with hypertrophic cardiomyopathy diagnosed by MRI were analysed. The global ventricular hypertrophy in 10(12. 50%) cases,the thickness of 25. 60±6. 93 mm.The localized hypertrophy in 70(87. 50% )cases,22. 98±5. 64 mm ;of them the septal hypertrophy in 31 (38. 75 % )cases, 22. 66 ± 5. 85 mm ; the free wall hypertrophy in 20 (25.00% ), 20. 65 ± 4. 07 mm ; the apical hypertrophy in 11 (13. 75% ) cases, 28. 27 ±5. 90 mm ; the combination of septum with free wall hypertrophy in 6(7. 50% )cases,22. 33±3. 14mm;the combination of apex with free wall hypertrophy in 1 case and the papillary muscular hypertrophy in 1 case. 29 (36. 25% )patients associated with left ventricular outnow tract obstruction. There were T wave abnormality on electrocardiograms in 60 cases, which accuounted for 75. 9%, ST segment depression only in 9(11. 39% )patients. That is available to differentiate from coronary artery disease. The left ventricular hypertrophy on electrocardiograms was common in global ventricular hypertrophy (80. 00% );TV5 inversion was seen frequently in nonseptal hypertrophyi the deepest T wave inversion was much more found in global ventricular hypertrophy but in apical hypertrophyl the distribution of abnormal Q wave was seen no differently among various subtypes.

关 键 词：肥厚型 心肌病 心电图 诊断 分型 

分 类 号：R542.204[医药卫生—心血管疾病]