扩张型心肌病合并心腔内血栓患者的临床特点分析  

Clinical Characteristics of Patients With Dilated Cardiomyopathy Complicating With Intracardiac Thrombus

作　　者：翟玫[1] 黄丽燕 王运红[1] 邹长虹[1] 周琼[1] 黄燕[1] 赵雪梅[1] 田鹏超 张宇辉[1] 张健[1] ZHAI Mei;HUANG Liyan;WANG Yunhong;ZOU Changhong;ZHOU Qiong;HUANG Yan;ZHAO Xuemei;TIAN Pengchao;ZHANG Yuhui;ZHANG Jian(Heart Failure Center,National Center for Cardiovascular Diseases and Fuwai Hospital,CAMS and PUMC,Beijing(100037),China)

机构地区：[1]中国医学科学院,北京协和医学院,国家心血管病中心,阜外医院,心力衰竭中心,北京市100037

出　　处：《中国循环杂志》2021年第6期563-566,共4页Chinese Circulation Journal

基　　金：国家重点研发计划项目(2017YFC1308301、2017YFC1308305)。

摘　　要：目的:了解扩张型心肌病(DCM)合并心腔内血栓(心内血栓)患者的临床特点,为进一步开展干预治疗研究提供数据基础。方法:连续入选2007年4月到2018年6月期间于中国医学科学院阜外医院心力衰竭中心重症监护病区住院,诊断为DCM或围生期心肌病或酒精性心肌病合并心内血栓患者。分析患者的人口学资料、检验/检查指标、主要合并症、药物应用、心内血栓分布等信息。结果:研究共入选277例患者。DCM患者心内血栓主要分布于左心室(77.6%),其次为左心房(20.2%)。围生期心肌病患者的左心室血栓最多见,达100%,其次是心肌致密化不全患者(83.3%)。左心室血栓更多见于左心室射血分数严重降低、心功能更差的患者,左心房血栓则反之。69.3%患者接受口服抗凝药治疗,华法林为最常用的抗凝药。结论:DCM患者合并心内血栓分布特点呈一定规律性,左心室是发生血栓最常见部位。Objectives:To investigate the clinical characteristics of patients with dilated cardiomyopathy(DCM)complicating with intracardiac thrombus,and to provide clinical data basis for further intervention therapy studies.Methods:Consecutive patients hospitalized in Fuwai Hospital from April 2007 to June 2018 were screened in this study,and patients diagnosed with"dilated cardiomyopathy"or"pregnancy cardiomyopathy"or"alcohol cardiomyopathy"complicating with"intracardiac thrombus"were enrolled.Results:A total of 277 patients were enrolled.Intracardiac thrombus in DCM patients mainly located in the left ventricle(77.6%),followed by the left atrium(20.2%).The incidence of left ventricular thrombus was the highest in patients with peripartum cardiomyopathy(100%),followed by patients with noncompaction of the ventricular myocardium(83.3%).The prevalence of left ventricular thrombus was more common in patients with severely reduced left ventricular ejection fraction and worse cardiac function,while the prevalence of left atrial thrombus was more common in patients with better left ventricular ejection fraction and cardiac function.Oral anticoagulants were applied in 69.3%of the patients,and warfarin was the most commonly used anticoagulant.Conclusions:There are distinct intracardiac thrombus distribution characteristics in DCM patients,and the left ventricle is the most common site of thrombosis.

关 键 词：扩张型心肌病 心内血栓 心力衰竭 

分 类 号：R54[医药卫生—心血管疾病]