扩张型心肌病临床特征及心脏病理分析  

Clinical features and cardiac pathological analysis of dilated cardiomyopathy

作　　者：邓保平[1,2] 郑俊猛[1] 梁毅[1] 吴颖猛[1] 黄伟钊[1] 姜海明[1] DENG Bao-ping;ZHENG Jun-meng;LIANG Yi;WU Ying-meng;HUANG Wei-chao;JIANG Hai-ming(Zhongshan People′s Hospital,Zhongshan,Guangdong 528403,China;Sun Yat-sen Memorial Hospital of Sun Yat-sen University,Guangzhou 510235,China)

机构地区：[1]中山市人民医院,广东中山528403 [2]中山大学孙逸仙纪念医院,广州510235

出　　处：《岭南心血管病杂志》2018年第1期83-86,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨终末期扩张型心肌病(dilated cardiomyopathy,DCM)的临床特点及心脏病理改变。方法分析中山市人民医院2006年1月至2016年1月19例因终末期DCM接受心脏移植患者的临床资料,着重分析其临床特征、超声心动图结果及心脏病理改变。同期选取11例因继发性心肌病接受心脏移植的患者作为对照组。结果终末期DCM患者临床症状主要表现胸闷气促,部分严重患者出现夜间阵发性呼吸困难,心悸不常见;超声心动图主要表现为左心室扩大并收缩功能障碍,心脏瓣膜出现不同程度反流,未见瓣膜增厚及钙化;病理光镜下见心肌纤维肥大变性,部分发生心肌纤维化或脂肪浸润,79%患者瓣膜出现黏液样变性。DCM组与对照组间瓣膜黏液样变性比较,差异有统计学意义(P<0.05)。结论与继发性心肌病相比较,DCM心脏瓣膜容易发生黏液样变性,瓣膜黏液样变性可能与DCM存在相关性。Objectives To explore clinical features and cardiac pathological changes of dilated cardiomyopathy(DCM).Methods Totally19patients with end-stage DCM treated with transplant from January2006to January2016in Zhongshan People′s Hospital were selected,and clinical symptoms,doppler echocardiography and pathological features of them were analyzed.At the same period,11patients with secondary myocardiopathy treated with transplant were selected as control group.Results Patients with end-stage DCM usually presented with paroxysmal dyspnea and even orthopnea,but seldom with palpitations.Echocardiography mainly shown left ventricular enlargement,systolic dysfunction and varying degrees of heart valve regurgitation.Thickening and calcification of valve were not found.Pathological studies indicated that areas of fibrofatty changed and features of myocardial fibers hypertrophy were not uncommon.Interestingly,79%of valves occurred myxoid degeneration.Valvular myxoid degeneration between DCM group and control group was significant different(P<0.05).Conclusions Patients with DCM are more tendency to occur myxoid degeneration when comparing with patients with secondary myocardiopathy.Valvular myxoid degeneration may correlatedwith DCM.

关 键 词：心肌病 心脏移植 超声心动图 病理改变 临床症状 

分 类 号：R542.2[医药卫生—心血管疾病]