冠状动脉造影的肥厚型心肌病患者118例分析

    Analysis of 118 patients with hypertrophic cardiomyopathy by coronary angiography

      摘要
    • 摘要:
        目的  分析做过冠状动脉造影(CAG)的肥厚型心肌病(HCM)患者并发冠心病或心肌桥的发生率，为此类患者的临床治疗提供指导。
        方法  选择做过CAG检查的118例经临床表现、心电图和超声心动图诊断为HCM患者，分析冠心病(> 50%主支血管狭窄)和心肌桥的患病率。
        结果  在做过CAG检查的HCM患者中，冠心病和心肌桥患病率分别为18.6%和44.1%（Nobel分类Ⅰ 级22%、Ⅱ级9.3%、Ⅲ级7.6%），既有冠心病又有心肌桥的患病率为5.1%。NobelⅡ级、Ⅲ级心肌桥在肥厚型梗阻性心肌病（HOCM）患者中发生率显著性增高。
        结论  CAG是HCM患者是否并发冠心病的一种可行、准确的有创检查手段。当患者年龄大于40岁、有高血压病、糖尿病等冠心病危险因素、严重胸痛与心电图有动态改变时，需要做CAG，以排除HCM并发冠心病。

       

      Abstract:
        AIM  to analyze the incidence of coronary heart disease or myocardial bridge (MB) in patients with hypertrophic cardiomyopathy (HCM) who have undergone coronary angiography (CAG), so as to provide guidance for the clinical treatment of such patients.
        METHODS  coronary angiography was performed in 118 patients with suspected coronary heart disease (CHD) diagnosed with HCM by clinical manifestation, electrocardiogram and echocardiography, and the prevalence of CAD(> 50% main branch stenosis) and MB was assessed.
        RESULTS  in patients with HCM, CAD and MB morbidity rates were 18.6% and44.1% respectively (Nobel classification Ⅰ level 22%, 9.3% 7.6%, Ⅱ Ⅲ level), there are both CAD and the prevalence of MB was 5.1%. Nobel Ⅱ, Ⅲ MB in patients with HOCM incidence increased significantly.
        Conclusions  CAG is a feasible and accurate invasive method for HCM patients with coronary heart disease. When the patient is over 40 years old, has the risk factors of coronary heart disease such as hypertension and diabetes, and has the dynamic changes of severe chest pain and ECG, CAG is needed to exclude HCM with coronary heart disease. disease risk factors such as hypertension, diabetes, severe chest pain and ecg dynamic changes, ICA is required to exclude HCM combined with CAD.

       

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