【摘要】 目的:探讨合并高血压的肥厚型梗阻性心肌病(hypertrophic obstructive cardiomyopathy,HOCM)患者的临床表现、超声心动图及预后特点。方法:入选HOCM患者80例,根据是否合并高血压将患者分为2组:合并高血压的HOCM患者为H-HOCM组(n=43),无高血压的HOCM患者为N-HOCM组(n=37)。随访并对比分析两组患者的临床资料。结果:与N-HOCM组患者相比,H-HOCM组患者年龄较大,合并糖尿病者较多,左室舒张末期内径和收缩末期内径增大,室间隔厚度降低(P<0.05)。药物治疗方面,两组患者β受体阻滞剂应用率均较高(>80%),H-HOCM组患者血管紧张素受体阻断剂(ARB)和血管紧张素转换酶抑制剂(ACEI)应用率明显高于NHOCM组(P<0.05)。随访期间两组患者临床相关事件发生率无统计学差异。结论:合并高血压的HOCM患者呈高龄趋势,多合并糖尿病,左室呈离心性肥厚,其预后特征有待深入观察。更多还原

【Abstract】 Objective:To investigate the clinical manifestation,echocardiography and prognosis in patients with hypertrophic obstructive cardiomyopathy(HOCM)accompanied with hypertension.Methods:A cohort of 80 patients with HOCM were enrolled and randomly divided into two groups according to blood pressure:H-HOCM group(with hypertension,n=43)and N-HOCM group(without hypertension,n=37).The clinical manifestation,echocardiography and prognosis of the two groups were compared. Results:Compared with N-HOCM group,patients in H-HOCM group were older and more likely to be combined with diabetes,and left ventricular end diastolic diameter and left ventricular end systolic diameter were significantly increased in these patients(P<0.05).Meanwhile,interventricular septal thickness was significantly decreased in H-HOCM group compared with N-HOCM group(P<0.05).The application rate ofβblockers was high(>80%)in patients of both groups.Both of angiotensin receptor blockers(ARB)and angiotension converting enzyme inhibitors(ACEI)were more frequently used in H-HOCM group than those in N-HOCM group(P<0.05).There was no significant difference in the incidence of clinically relevant events between the two groups. Conclusion:H-HOCM patients tend to be older and combined with diabetes,and their left ventricle presents eccentric hypertrophy,but prognosis needs further study.更多还原