冠状动脉造影的肥厚型心肌病患者118例分析  

Analysis of 118 patients with hypertrophic cardiomyopathy by coronary angiography

作　　者：马志玲 孙冬冬 邵虹 严青青 卜令程 刘亚利 MA Zhi-ling;SUN Dong-dong;SHAO Hong;YAN Qing-qing;BO Ling-cheng;LIU Ya-li(Department of Cardiology,Xijing Hospital,Air Force Medical University,Xi’an 710032,Shaanxi,China)

机构地区：[1]空军军医大学西京医院心脏内科,陕西西安710032

出　　处：《心脏杂志》2020年第6期591-594,共4页Chinese Heart Journal

基　　金：科技部国家国际合作专项基金资助(2014DFA31980);国家自然科学基金项目资助(81170305,30371571,81470452)。

摘　　要：目的分析做过冠状动脉造影(CAG)的肥厚型心肌病(HCM)患者并发冠心病或心肌桥的发生率,为此类患者的临床治疗提供指导。方法选择做过CAG检查的118例经临床表现、心电图和超声心动图诊断为HCM患者,分析冠心病(>50%主支血管狭窄)和心肌桥的患病率。结果在做过CAG检查的HCM患者中,冠心病和心肌桥患病率分别为18.6%和44.1%(Nobel分类Ⅰ级22%、Ⅱ级9.3%、Ⅲ级7.6%),既有冠心病又有心肌桥的患病率为5.1%。NobelⅡ级、Ⅲ级心肌桥在肥厚型梗阻性心肌病(HOCM)患者中发生率显著性增高。结论CAG是HCM患者是否并发冠心病的一种可行、准确的有创检查手段。当患者年龄大于40岁、有高血压病、糖尿病等冠心病危险因素、严重胸痛与心电图有动态改变时,需要做CAG,以排除HCM并发冠心病。AIM to analyze the incidence of coronary heart disease or myocardial bridge(MB)in patients with hypertrophic cardiomyopathy(HCM)who have undergone coronary angiography(CAG),so as to provide guidance for the clinical treatment of such patients.METHODS coronary angiography was performed in 118 patients with suspected coronary heart disease(CHD)diagnosed with HCM by clinical manifestation,electrocardiogram and echocardiography,and the prevalence of CAD(>50%main branch stenosis)and MB was assessed.RESULTS in patients with HCM,CAD and MB morbidity rates were 18.6%and44.1%respectively(Nobel classificationⅠlevel 22%,9.3%7.6%,ⅡⅢlevel),there are both CAD and the prevalence of MB was 5.1%.NobelⅡ,ⅢMB in patients with HOCM incidence increased significantly.Conclusions CAG is a feasible and accurate invasive method for HCM patients with coronary heart disease.When the patient is over 40 years old,has the risk factors of coronary heart disease such as hypertension and diabetes,and has the dynamic changes of severe chest pain and ECG,CAG is needed to exclude HCM with coronary heart disease.disease risk factors such as hypertension,diabetes,severe chest pain and ecg dynamic changes,ICA is required to exclude HCM combined with CAD.

关 键 词：肥厚型心肌病 冠状动脉造影术 

分 类 号：R542.2[医药卫生—心血管疾病]