扩张型左室致密化不全心肌病与扩张型心肌病的临床特点及预后对比研究  

A comparative study on clinical features and prognosis between dilated left ventricular non-compaction cardiomyopathy and dilated cardiomyopathy

作　　者：宁莉莉 冯云飞 王海强 杨巧妮 马爱群[3] 王亭忠[1] Ning Lili;Feng Yunfei;Wang Haiqiang;Yang Qiaoni;Ma Aiqun;Wang Tingzhong(The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China;不详)

机构地区：[1]西安交通大学第一附属医院,西安710061 [2]空军第九八六医院心内科,西安710054 [3]西安交通大学第一附属医院心内科,西安710061

出　　处：《中国循证心血管医学杂志》2023年第8期982-985,989,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的 对比扩张型左室致密化不全心肌病(Dilated LVNC)与扩张型心肌病(DCM)的临床特点及预后相关因素,为两种疾病的鉴别诊断寻找依据。方法 回顾性分析西安交通大学第一附属医院收治的35例Dilated LVNC患者与35例DCM患者的临床特征以及心电图、心脏超声、心脏磁共振、血液指标检查结果,随访并进行生存分析。结果 两组患者的临床特征无显著性差异(P>0.05)。与DCM组相比,Dilated LVNC组患者心律失常(P=0.004)、ST-T改变(P=0.000)、非心肌梗死性Q波(P=0.001)、胸部导联递增不良(P=0.004)、左室壁收缩期增厚率减低(P=0.002)的发生率更高,而肺动脉高压(P=0.016)、左房扩大(P=0.000)、右房扩大(P=0.012)、右室扩大(P=0.029)、全心扩大(P=0.003)的发生率更低。Kaplan-Meier生存分析显示两组患者的主要心血管不良事件发生率、心力衰竭再住院率、心血管死亡率均无显著性差异(P>0.05)。结论 Dilated LVNC组患者心电图异常发生率更高,主要为左心室扩大,而DCM组患者主要为左心扩大和全心扩大。Objective The objective of this study is to compare the clinical features and prognostic factors between dilated left ventricular non-compaction cardiomyopathy(Dilated LVNC) and dilated cardiomyopathy(DCM)in order to establish a basis for distinguishing between the two diseases.Methods A retrospective analysis was conducted on 35 patients with Dilated LVNC and 35 patients with DCM who were admitted to the First Affiliated Hospital of Xi'an Jiaotong University.The analysis included evaluation of clinical characteristics,electrocardiography(ECG),echocardiography,cardiac magnetic resonance imaging,blood tests,and follow-up survival analysis.Results There were no significant differences in clinical characteristics between the Dilated LVNC group and the DCM group(P>0.05).Compared to the DCM group,the Dilated LVNC group had a higher incidence of arrhythmias(P=0.004),ST-T changes(P=0.000),non-myocardial infarction Q waves(P=0.001),poor progression of chest leads(P=0.004),and reduced systolic thickening rate of the left ventricular wall(P=0.002).Furthermore,the Dilated LVNC group had a lower incidence of pulmonary hypertension(P=0.016),left atrial enlargement(P=0.000),right atrial enlargement(P=0.012),right ventricular enlargement(P=0.029),and whole heart enlargement(P=0.003).Kaplan-Meier survival analysis revealed no significant differences in the incidence of major adverse cardiovascular events,heart failure rehospitalization,and cardiovascular death between the two groups(P>0.05).Conclusion The Dilated LVNC group exhibited a higher incidence of abnormal ECG findings,primarily left ventricular enlargement,while the DCM group predominantly showed left heart enlargement and whole heart enlargement.

关 键 词：扩张型左室致密化不全心肌病 扩张型心肌病 临床特点 预后 鉴别诊断 

分 类 号：R542.2[医药卫生—心血管疾病]