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目的探讨肥厚型心肌病患者出现晕厥的临床特点。方法将92例经超声心动图诊断为肥厚型心肌病的住院患者分为晕厥发作组(18例)和无晕厥发作组(74例),就两组的临床特征、心电变化和超声心动图特点进行分析。结果晕厥组发生流出道梗阻者[8例(44.4%)]明显超过非晕厥组[11例(14.9%)](P=0.005)。晕厥组心肌肥厚部位以室间隔肥厚为主者多见[15例(83.3%)];晕厥组室间隔的厚度[(2.18±0.24)cm]明显高于无晕厥组[(1.91±0.20)cm](P=0.000)。晕厥组快速性心律失常的发生例数[11例(61%)]明显多于非晕厥组[18例(24%)](P=0.003)。晕厥组QRS波的宽度[(0.107±0.020)s]明显大于无晕厥组[(0.094±0.018)s](P=0.009)。晕厥组的ST段下移超过0.1mV的例数[10例(55.6%)]明显多于无晕厥组[22例(29.7%)](P=0.039)。结论肥厚型心肌病患者中,晕厥者主要与流出道梗阻有关。晕厥以室间隔肥厚为主者多见,与室间隔的厚度相关,易发生快速性心律失常。晕厥者的心肌结构排列紊乱和心电紊乱可能更严重。
Objective To investigate the clinical features of syncope in patients with hypertrophic cardiomyopathy. Methods 92 hospitalized patients diagnosed as hypertrophic cardiomyopathy by echocardiography were divided into two groups: the seizure group (n = 18) and the seizure free group (n = 74). The clinical characteristics, electrocardiographic changes and echocardiography Features for analysis. Results Out-stream obstruction occurred in syncope group (8 cases, 44.4%), significantly higher than those in non-syncope group (11 cases, 14.9%) (P = 0.005). The thickness of ventricular septum in syncope group [(2.18 ± 0.24) cm] was significantly higher than that in non-syncope group [(1.91 ± 0.20) cm ] (P = 0.000). The incidence of tachyarrhythmia in the syncope group was significantly higher in 11 patients (61%) than in the non-syncope group (18 patients [24%]) (P = 0.003). The width of QRS wave in syncope group [(0.107 ± 0.020) s] was significantly higher than that in no syncope group [(0.094 ± 0.018) s] (P = 0.009). In the syncope group, the number of ST-segment down more than 0.1mV (10 cases (55.6%)] was significantly higher than that of the non-syncope group [22 cases (29.7%)] (P = 0.039). Conclusions In patients with hypertrophic cardiomyopathy, the main cause of syncope is outflow tract obstruction. Syncope to septal hypertrophy are more common, and the thickness of the interventricular septum, prone to tachyarrhythmia. Syncope myocardial structure disorder and ECG disorders may be more serious.