摘要
目的 分析 85例肥厚型心肌病 (HCM )患者心电图、长程心电图及临床资料 ,探讨HCM患者心律失常发生情况及其与猝死及晕厥的关系。方法 收集 85例确诊的HCM患者临床资料、心电图、长程心电图记录 ,分析快速型及缓慢型心律失常的发生情况及其与晕厥和猝死的关系 ,同时结合超声心动图资料 ,分析心律失常与心肌结构的关系。结果 85例HCM中有心律失常者 74例 ,占 87% (包括快速型心律失常 30例 ,发生率为 35 3% ;缓慢性型心律失常 2 1例 ,发生率为2 4 7% ) ;有晕厥史的 2 4例患者中 ,室内传导阻滞、快速心律失常及缓慢型心律失常的发生率较无晕厥史患者中的发生率高 ,并有明显统计学差异 ,且以室间隔中下部及心尖部肥厚的发生率为高 ;此外 ,缓慢型心律失常与快速型心律失常患者相比室间隔中下部及心尖部肥厚的发生率较高。结论 肥厚型心肌病发生晕厥、猝死的原因不仅仅是由于快速型心律失常 ,缓慢型心律失常也是其重要原因之一 ,且在有晕厥史或缓慢性心律失常者以室间隔中下部及心尖部肥厚者多见。
Objective To investigate the patterns of arrhythmias in patients with hypertrophic cardiomyopathy (HCM) and its relation with the pathology of heart. Methods The clinical data, electrical cardiogram (ECG), Holter ECG recordings, and echocardiograms of 85 patients with HCM were collected and analyzed. Results Seventy four (87%) of the 85 patients with HCM had various forms of arrhythmia, including tachycardia in 30 patients with a prevalence of 35.3%, and bradycardia in 21 patients with a prevalence of 24.7%. The incidence rates of intraventricular conduction block and tachycardiac arrhythmia of the 24 HCM patients with syncope history were 45.8% and 50.0% respectively, both significantly higher than those of the 61 HCM patients without syncope history (21.3% and 26.2% respectively, both P>0.05). The incidence rate of bradycardiac arrhythmia of the 24 HCM patients with syncope history was 50.0%, significantly higher than that of the 61 patients without syncope history (14.8%, P<0.001). Arrhythmia, especially bradycardia, was more frequent in the patients with hypertrophy in mid-low part of interventricular septum and cardiac apex. Conclusion Most patients with HCM have various cardiac arrhythmias, and occurrence of syncope and cardiac sudden death in the patients may be caused not only by tachycardia but also by bradycardia. Bradycardia is more frequent in the patients with hypertrophy in mid-low part of interventricular and cardiac apex.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2004年第5期401-404,共4页
National Medical Journal of China
关键词
肥厚型心肌病
心律失常
猝死
晕厥
心电图
Cardionyopathy, hypertrophic
Arrhythmia
Death, sudden
Syncope
