成人心肌致密化不全13例临床特征及预后分析  

Clinical features and prognostic analysis on the thirteen adult patients with noncompaction of ventricular myocardium

作　　者：李胜利[1] 李牧蔚[2] 

机构地区：[1]商丘市第一人民医院心血管内科,河南476100 [2]河南省人民医院心血管内科,郑州450008

出　　处：《中国临床新医学》2015年第9期830-832,共3页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的分析成人心肌致密化不全患者的临床特征及其预后情况，以期提高对该病的认识。方法回顾性分析2008-03～2013-05该院收治的13例成人心肌致密化不全患者的临床资料。结果13例患者误诊为扩张型心肌病8例，冠心病3例，心脏瓣膜性病2例。超声心动图检查左房、左室受累12例，累及左、右房室1例，射血分数〈50％者9例，室壁运动弥漫性减低7例。12例患者合并不同类型心律失常，1例心电图未见明显异常。针对患者并发症给予控制心力衰竭，纠正心律失常发作等治疗，2例无症状者未予药物治疗。随访12～26个月，心力衰竭者左心室进行性扩大，1例合并主动脉瓣关闭不全者和1例心功能NY-HAⅣ级患者死亡，2例发生血栓事件。结论成人心肌致密化不全临床表现差异较大，应注重提高内科及超声科医师对该病的认识，减少漏、误诊发生，以利尽早积极对症治疗，改善患者预后。Objective To explore the clinical features and prognosis on the adult patients with noncompaction of ventricular myocardium( NVM). Methods The data of 13 adult patients with NVM from March 2008 to May2013 were analyzed retrospectively. Results Among all patients,8 patients were misdiagnosed as dilated cardiomyopathy,3 patients were misdiagnosed as coronary heart disease and 2 patients were misdiagnosed as heart valve disease. Examined by echocardiography,12 cases were found having left atrium and left ventricular dysfunction,1 case having left and right atrioventricular dysfunction. Ejection fraction was less than 50% in 9 cases. Ventricular wall motion diffuse was decreased in 7 cases. 12 cases suffered from different types of arrhythmia,while electrocardiogram retain normal in 1 case. Cardiac failure,arrhythmia and other complications were controlled when needed. 2 patients with no symptoms didn't take any medication. After a follow-up for 12 to 26 months,left ventricle was progressively amplified in all patients with cardiac failure,with aortic insufficiency in 1 case,thrombosis in 2 cases and cardiac function NYHAⅣ in 1 case. Conclusion There are great differences of the clinical manifestations among the patients with NVM. Awareness of the disease should be raised in physicians and ultrasound doctors to recognize it better and to reduce missing diagnosis and to improve the patients' prognosis.

关 键 词：心肌致密化不全 成人 临床特征 预后 

分 类 号：R542.2[医药卫生—心血管疾病]