肥厚性心肌病心源性猝死的危险因素分析  

The Analysis of the Risk Factors of Sudden Cardiac Death in Hypertrophic Cardiomyopathy

作　　者：黄艳梅[1] 别彩群[1] 董丽妍[1] 孙士敏[1] 

机构地区：[1]广州医学院附属深圳沙井医院,广东深圳518104

出　　处：《河北医学》2012年第6期756-759,共4页Hebei Medicine

摘　　要：目的:分析肥厚性心肌病心源性猝死的危险因素。方法:收集发生心源性猝死的肥厚性心肌病患者32例,所有患者均经临床表现、实验室检查、心电图及超声心动图检查确诊,回顾性分析患者的临床资料。结果:单因素分析显示心脏骤停(心室颤动),自发性持续性室速,猝死家族史(≤40岁的一级亲属),晕厥(≥2次/年),左室厚度≥30mm,负荷或运动后收缩压反应异常(无变化或降低>10mmHg或升高<25mmHg),非持续性室速,左室流出道梗阻(压力差>30mmHg)等因素为肥厚性心肌病患者发生心源性猝死的危险因素(P<0.01)。多因素logistic分析显示心脏骤停(心室颤动),自发性持续性室速,猝死家族史及晕厥≥2次/年是肥厚性心肌病心源性猝死重要的危险因素。结论:多种危险因素与肥厚性心肌病心源性猝死密切相关,临床工作中应该积极应对。Objective： To analyze the risk factors of sudden cardiac death in hypertrophic cardiomyopathy. Method： 32 hypertrophic cardiomyopathy patients with occurrence of sudden cardiac death were chosen, all patients were confirmed by clinical manifestations, laboratory tests, ECG and echocardiography diagnosis, the clinical data was retrospectively analyzed. Result： Univariate analysis showed that cardiac arrest （ ventricular fibrillation ） , spontaneous sustained ventricular tachycardia, family history of sudden death （ ≤ 40-year-old first-degree relatives ） , syncope（ ≥2 times/year） , left ventricular thickness was more than 30mm, systolic blood pressure response after exercise load or abnormal （no change or decrease〉10mmHg or increase 〈25mmHg ） , non-sustained ventricular tachycardia, left ventricular outflow tract obstruction （ pressure gradient〉30mmHg ） were factors for the occurrence of sudden cardiac death in patients with hypertrophic cardiomyopathy（P〈0.01）. Multiple logistic analysis showed that cardiac arrest （ ventricular fibrillation）, spontaneous sustained ventricular tachycardia, family history of sudden death and syncope was more than 2 times in a year were important risk factor for the occurrence of sudden cardiac death in patients with hypertrophic cardiomyopathy. Conclusion： Multiple risk factors are closely related with sudden cardiac death in patients with hypertrophic cardiomyopathy, we should take positive approach.

关 键 词：心肌病 肥厚性 心源性猝死 因素 

分 类 号：R542.2[医药卫生—心血管疾病]