【摘要】 目的探讨终末期扩张型心肌病(dilated cardiomyopathy,DCM)的临床特点及心脏病理改变。方法分析中山市人民医院2006年1月至2016年1月19例因终末期DCM接受心脏移植患者的临床资料,着重分析其临床特征、超声心动图结果及心脏病理改变。同期选取11例因继发性心肌病接受心脏移植的患者作为对照组。结果终末期DCM患者临床症状主要表现胸闷气促,部分严重患者出现夜间阵发性呼吸困难,心悸不常见;超声心动图主要表现为左心室扩大并收缩功能障碍,心脏瓣膜出现不同程度反流,未见瓣膜增厚及钙化;病理光镜下见心肌纤维肥大变性,部分发生心肌纤维化或脂肪浸润,79%患者瓣膜出现黏液样变性。DCM组与对照组间瓣膜黏液样变性比较,差异有统计学意义(P<0.05)。结论与继发性心肌病相比较,DCM心脏瓣膜容易发生黏液样变性,瓣膜黏液样变性可能与DCM存在相关性。更多还原

【Abstract】 Objectives To explore clinical features and cardiac pathological changes of dilated cardiomyopathy(DCM). Methods Totally 19 patients with end-stage DCM treated with transplant from January2006 to January 2016 in Zhongshan People′s Hospital were selected,and clinical symptoms,doppler echocardiography and pathological fea-tures of them were analyzed. At the same period,11 patients with secondary myocardiopathy treated with transplantwere selected as control group. Results Patients with end-stage DCM usually presented with paroxysmal dyspnea andeven orthopnea,but seldom with palpitations. Echocardiography mainly shown left ventricular enlargement,systolic dys-function and varying degrees of heart valve regurgitation. Thickening and calcification of valve were not found. Pathologi-cal studies indicated that areas of fibrofatty changed and features of myocardial fibers hypertrophy were not uncommon.Interestingly,79% of valves occurred myxoid degeneration.Valvular myxoid degeneration between DCM group and con-trol group was significant different(P<0.05). Conclusions Patients with DCM are more tendency to occur myxoiddegeneration when comparing with patients with secondary myocardiopathy. Valvular myxoid degeneration may correlatedwith DCM.更多还原