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扩张型心肌病以右心衰竭为主患者的临床资料分析

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目的 回顾性分析扩张型心肌病(DCM)患者的临床资料,与DCM单纯左心衰竭组和单纯右心衰竭组相比,以右心衰竭为主要临床表现的DCM组的临床特征.方法 回顾性分析2013年1月~2017年1月,住院患者中诊断为DCM的患者,其中以右心衰竭为主DCM组25例,单纯左心衰竭DCM组55例,单纯右心衰竭DCM组10例.分析3组的人口统计学和临床基本资料、超声心动图、心功能及肝功能等指标的差异.结果 以右心衰竭为主DCM组的人口统计学和临床基本资料与单纯左心衰竭DCM组和单纯右心衰竭DCM组相比差异无统计学意义.通过数据分析右心衰竭为主DCM组、单纯左心衰竭DCM组、单纯右心衰竭DCM组,左心室舒张末期直径(LVEDD)分别为[(76.3±13.7)mm、(67.6±12.3)mm、(59.4±4.2)mm],左心房内径(LA)分别为[(58.5±9.3)mm、(47.4±7.2)mm、(49.0±6.5)mm],肺动脉压力(SPAP)分别为[(55.2±12.4)mmHg、(37.8±7.7)mmHg、(35.9±7.1)mmHg],左心室射血分数(LVEF)分别为[(25.5±12.6)%、(34.4±13.6)%、(43.6±7.3)%],心包积液发生率分别为(9/25、6/55、1/10),血浆脑钠肽(BNP)分别为[(1378.3±441.6)ng/mL、(897.2±353.4)ng/mL、(766.4±381.7)ng/mL],并且右心衰竭为主DCM组分别与单纯左心衰竭DCM组和单纯右心衰竭DCM组在LVEDD、LA、肺动脉压力、LVEF、心包积液发生率、BNP两两比较上均具有统计学差异(均P<0.05).而血清胆红素水平则表现为右心衰竭为主DCM组显著高于单纯左心衰竭DCM组[(44.6±28.3)μmol/L、(20.1±11.7)μmol/L,P<0.05],与单纯右心衰竭DCM组相比无统计学差异.结论 右心衰竭为主DCM患者心脏扩大更显著,肺动脉压力更高,心功能和肝功能更差,预后更差.
Comparison on clinical features between dilated cardiomyopathy patients with or without right heart failure
Objective To compared the clinical data of dilated cardiomyopathy (DCM) patients who were only left or right heart failure with the DCM patients who were right heart failure as the main clinical manifestations. Methods During January 2013 to January 2017, 25 cases of DCM with right heart failure as the main clinical manifestations, 55 cases of DCM with only left heart failure and 10 cases of DCM with only right heart failure were admitted in our department. The demographic and clinical data, echocardiography, brain natriuretic peptide(BNP) and serum total bilirubin were analyzed. Results Sex, age, course of disease and vital signs were similar between the three groups, while the left ventricular end diastolic diamesion[(76.3±13.7)mm,(67.6±12.3)mm, (59.4±4.2)mm], dimension of the left atrium[(58.5±9.3)mm, (47.4±7.2)mm, (49.0±6.5) mm], pulmonary artery pressure[(55.2±12.4)mmHg, (37.8±7.7)mmHg, (35.9±7.1)mmHg], incidence of pericardial effusion(9/25, 6/55, 1/10), BNP level[(1378.3±441.6)ng/mL, (897.2±353.4)ng/mL (766.4±381.7)ng/mL] were significantly higher while left ventricular ejection fraction(LVEF) was significantly lower in DCM with right heart failure as the main clinical manifestations than those in DCM with only left or right heart failure[(44.6±28.3)μmol/L, (20.1±11.7) μmol/L,P<0.05]. Conclusion DCM patients with right heart failure as the main clinical manifestations is linked with worse clinical features than DCM patients with only left or right heart failure.

cardiomyopathydilatedright heart failureechocardiography

曹建成

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浙江省湖州市第一人民医院 心内科,浙江 湖州 313000

心肌病 扩张型 右心衰竭 超声心动图

2017

中国生化药物杂志
南京生物化学制药研究所,全国生化制药情报中心站,中国生化制药工业协会,中国药品生物制品检定所

中国生化药物杂志

ISSN:1005-1678
年,卷(期):2017.37(10)
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