心尖肥厚型心肌病患者的心律失常特點(diǎn)研究

秦淑娟

[摘要] 目的 從生化指標(biāo)表達(dá)、超聲心動(dòng)圖表現(xiàn)及預(yù)后3方面分析心尖肥厚型心肌病患者合并發(fā)生心律失常后的特點(diǎn)。 方法 方便選取2013年4月—2015年10月期間北京阜外醫(yī)院/成都市第三人民醫(yī)院收治的87例心尖肥厚型心肌病患者作為研究對(duì)象，根據(jù)是否合并心律失常將87例患者分為觀察組（合并心律失常）和對(duì)照組（未合并心律失常），收集兩組患者生化指標(biāo)檢測(cè)結(jié)果、超聲心動(dòng)圖檢查結(jié)果、臨床治療及預(yù)后資料，進(jìn)行數(shù)據(jù)統(tǒng)計(jì)分析，從上述3個(gè)方面總結(jié)心尖肥厚型心肌病患者的心律失常特點(diǎn)。 結(jié)果 觀察組合并心律失常的類型包括心房撲動(dòng)、竇性心動(dòng)過(guò)緩、心房顫動(dòng)、室性心律失常、房室傳導(dǎo)阻滯。生化指標(biāo)，觀察組患者的TG為（1.53±0.35）mmol/L，低于對(duì)照組的為（2.30±0.39）mmol/L（t=6.571；P<0.05），NT-pro BNP為（2.93±0.35）pmol/L，高于對(duì)照組的（2.26±0.41）pmol/L（t=5.558；P<0.05），其他生化指標(biāo)檢測(cè)結(jié)果比較差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）。超聲心動(dòng)圖檢查結(jié)果，觀察組中心律失常組類型為心房顫動(dòng)的患者左心房前后徑為（40.05±5.02）mm，大于對(duì)照組患者的（34.91±4.88）mm（t=3.283；P<0.05）。其他參數(shù)比較差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）。觀察組患者隨訪期間的心臟不良事件發(fā)生率為8.16%、死亡率為4.08%，與對(duì)照組患者的5.26%、2.63%比較差異無(wú)統(tǒng)計(jì)學(xué)意義（χ2=0.713、0.135，P>0.05）。 結(jié)論 心律失常作為心尖肥厚型心肌病患者的常見(jiàn)臨床表現(xiàn)，類型較多，包括心房撲動(dòng)、竇性心動(dòng)過(guò)緩、室性心律失常等，但合并發(fā)生后并不會(huì)出現(xiàn)較多特異性表現(xiàn)，對(duì)患者預(yù)后無(wú)明顯影響。

[關(guān)鍵詞] 心尖肥厚型心肌?。怀曅膭?dòng)圖；生化指標(biāo)

[中圖分類號(hào)] R542.2 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1674-0742（2019）02（b）-0025-03

Arrhythmia Characteristics in Patients with Apical Hypertrophic Cardiomyopathy

QIN Shu-juan

Institute of Cardiovascular Diseases， Chengdu Third People's Hospital， Chengdu， Sichuan Province， 610031 China

[Abstract] Objective To analyze the characteristics of arrhythmia patients with apical hypertrophic cardiomyopathy after biochemical index expression， echocardiographic findings and prognosis. Methods From April 2013 to October 2015， 87 patients with apical hypertrophic cardiomyopathy admitted to Beijing Fuwai Hospital/Chengdu Third People's Hospital were convenient included in the study. 87 patients were divided into observation group according to whether or not they had arrhythmia combined arrhythmia and control group （without arrhythmia）， biochemical indicators， echocardiography， clinical treatment and prognosis data were collected from two groups， and statistical analysis was performed. The apical hypertrophic myocardium was summarized from the above three aspects. Arrhythmia characteristics of patients. Results The types of combined arrhythmias were observed including atrial flutter， sinus bradycardia， atrial fibrillation， ventricular arrhythmia， and atrioventricular block. The TG of the observation group was （1.53±0.35） mmol/L， which was lower than that of the control group （2.30±0.39） mmol/L （t=6.571； P<0.05）， and NT-pro BNP was （2.93±0.35） pmol/L， which was higher than that of the control group （2.26±0.41） pmol/L （t=5.558； P<0.05）. There was no significant difference between the other biochemical indicators （P>0.05）. According to the results of echocardiography， the left atrial anteroposterior diameter of the patients with atrial fibrillation in the observation group was （40.05±5.02） mm， which was greater than that of the control group （34.91±4.88） mm （t=3.283； P<0.05）. There were no significant differences in other parameters （P>0.05）. The incidence of cardiac adverse events during the follow-up period was 8.16% and the mortality rate was 4.08%. There was no significant difference between the control group of （5.26%， 2.63%） （χ2=0.713， 0.135， P>0.05）. Conclusion Arrhythmia is a common clinical manifestation of patients with apical hypertrophic cardiomyopathy. There are many types， including atrial flutter， sinus bradycardia， ventricular arrhythmia， etc.， but there will be no more specific manifestations after the merger. There is no significant effect on the prognosis of patients.