老年人肥厚型心肌病

摘要

目的 探讨我国老年人肥厚性心肌病(HCM)患者的临床特点. 方法 连续入选2002年9月至2008年9月在我院注册的HCM患者711例.记录临床资料,分析年龄≥65岁与非老年患者的差异. 结果 711例HCM患者中老年人共103例(14.5%),与非老年患者比较,老年HCM患者中女性较多(52.5%与29.0%,P<0.01),并存疾病多(64.1%与25.0%,P<0.01),心房颤动发生率高(21.4%与14.0%,P<0.05).心功能不全是老年人HCM最常见的症状,年龄(r=0.213,P<0.05)、左心房扩大(r=0.308,P<0.01)和心房颤动(r=0.362,P<0.01)是影响心功能的主要因素.24%患者有1个以上心原性猝死主要风险因素,以晕厥最常见. 结论 老年HCM患者具有并存疾病和心房颤动发生率高、心功能更差等特点,老年患者HCM相关的心原性猝死风险评价应予以重视.%Objective To explore the clinical features of hypertrophic cardiomyopathy (HCM) in aged patients in China. Methods The 711 patients with HCM in our hospital from Sep 2002 to Sep 2008 were retrospectively reviewed. Clinical data were compared between patients older and younger than 65 years. Results The 103 patients(14.5%) were older than 65 years. Compared with those patients younger than 65 years, the aged patients had a higher prevalence in female (52. 5 vs 29. 0%, P<0. 01), in comorbidity (64. 1% vs 25.0%, P<0, 01)and in atrial fibrillation (21.4% vs 14.0%, P<0. 05). Cardiac insufficiency was the most common symptom in aged patients with HCM. The age(r=0. 213, P<0. 05), size of left atrium (r=0. 308, P<0. 01) and atrial fibrillation (r= 0. 362, P<0. 01) had significant correlation with heart function. The 24 % of patients had one or more major risks for HCM-related sudden cardiac death (SCD), among which syncope was most common. Conclusions A higher prevalence of comorbidity, a higher incidence of atrial fibrillation and worse heart function existed in aged patients with HCM. The major risks for HCM-related SCD should not be neglected in evaluation for aged patients.