合并高血压的肥厚型梗阻性心肌病患者的临床特点分析  

Clinical characteristics of patients with hypertrophic obstructive cardiomyopathy accompanied with hypertension

作　　者：刘榜霞 李小荣 杜为 王林林 满艺龙 肖峰 屠苏 汪道武 曹克将 

机构地区：[1]南京医科大学第一附属医院心血管内科,江苏省心肺疾病研究所,210029

出　　处：《国际心血管病杂志》2014年第3期195-197,共3页International Journal of Cardiovascular Disease

基　　金：国家重点基础研究发展计划;973计划(2013CB531105);国家"十二五"科技支撑计划项目(2011BAI11B13);国家自然科学基金(81170159);江苏高校优势学科建设工程;江苏省心血管病临床医学研究中心项目(BL2012011);江苏省人民医院创新团队基金(IRT-014)

摘　　要：目的:探讨合并高血压的肥厚型梗阻性心肌病(hypertrophic obstructive cardiomyopathy,HOCM)患者的临床表现、超声心动图及预后特点。方法:入选HOCM患者80例,根据是否合并高血压将患者分为2组:合并高血压的HOCM患者为H-HOCM组(n=43),无高血压的HOCM患者为N-HOCM组(n=37)。随访并对比分析两组患者的临床资料。结果:与N-HOCM组患者相比,H-HOCM组患者年龄较大,合并糖尿病者较多,左室舒张末期内径和收缩末期内径增大,室间隔厚度降低(P<0.05)。药物治疗方面,两组患者β受体阻滞剂应用率均较高(>80%),H-HOCM组患者血管紧张素受体阻断剂(ARB)和血管紧张素转换酶抑制剂(ACEI)应用率明显高于NHOCM组(P<0.05)。随访期间两组患者临床相关事件发生率无统计学差异。结论:合并高血压的HOCM患者呈高龄趋势,多合并糖尿病,左室呈离心性肥厚,其预后特征有待深入观察。Objective：To investigate the clinical manifestation,echocardiography and prognosis in patients with hypertrophic obstructive cardiomyopathy （HOCM） accompanied with hypertension.Methods：A cohort of 80 patients with HOCM were enrolled and randomly divided into twc groups according to blood pressure：H-HOCM group （with hypertension,n =43） and N-HOCM group （without hypertension,n =37）.The clinical manifestation,echocardiography and prognosis of the two groups were compared.Results：Compared with N-HOCM group,patients in H-HOCM group were older and more likely to be combined with diabetes,and left ventricular end diastolic diameter and left ventricular end systolic diameter were significantly increased in these patients（P＜0.05）.Meanwhile,interventricular septal thickness was significantly decreased in H-HOCM group compared with N-HOCMgroup （P＜0.05）.The application rate of β blockers was high （＞80 ％） in patients of both grou（p）s.Both of angiotensin receptor blockers （ARB） and angiotension converting enzyme inhibitors （ACEI） were more frequently used in H-HOCM group than those in N-HOCM group（P＜0.05）.There was no significant difference in the incidence of clinically relevant events between the two groups.Conclusion：H-HOCM patients tend to be older and combined with diabetes,and their left ventricle presents eccentric hypertrophy,but prognosis needs further study.

关 键 词：肥厚型梗阻性心肌病 高血压病 超声心动图 

分 类 号：R542.2[医药卫生—心血管疾病]