酒精性心肌病患者的临床特征分析

发布时间：2018-06-04 10:09

本文选题：酒精性心肌病 + 扩张型心肌病　；参考：《遵义医学院》2016年硕士论文

【摘要】：目的:通过比较分析遵义医学院第一附属医院及第三附属医院心内科酒精性心肌病(Alcoholic myocardiopathy,ACM)患者与扩张型心肌病(Dilated cardiomyopathy,DCM)患者的临床资料,初步了解酒精性心肌病患者临床特点。方法:收集并整理2013年1月至2015年12月在遵义医学院第一附属医院及第三附属医院心内科就诊、临床诊断为ACM及DCM患者的病历资料,以同期有大量饮酒史、心脏结构及功能正常的健康体检者40例为对照组。比较分析三组患者间年龄、病史、心电图、心脏彩超等临床资料差别。结果:1.共纳入研究的ACM患者为89人,全为男性;DCM患者为560人(其中男性341人,女性219人,男女比例为1.6:1);ACM与DCM之比为1:6.29(15.9%),其中ACM患者占心内科总住院人数0.35%(89/25191),DCM占2.22%(560/25191);ACM组及DCM组患者心功能NYHA III级所占比例最高分别为58.4%(52/89),59.5%(333/560)。2.ACM与DCM患者超声心动图类似,但ACM患者以全心增大为著,为49.4%(44/89),DCM患者以左房及左室增大为著,为69.5%(389/560);ACM患者可出现多种心律失常,最常见的心律失常为房性心律失常及左束支传导阻滞,但DCM组左束支传导阻滞所占比例明显高于ACM组。3.ACM组及DCM组患者血清中UA、Cr,AST,ALT、NT-pro BNP水平较对照组明显增高,ACM与DCM组比较,Cr,UA,AST,ALT水平增加更明显;ACM组与DCM组及对照组相比,高密度脂蛋白胆固醇水平明显减低,ACM组与对照组相比,甘油三酯水平明显增高;ACM患者UA水平随着NYHA心功能分级严重程度的增加而有所增加。结论:近3年数据表明,ACM及DCM患者来院就诊时心功能多已达NYHA III级。ACM与DCM患者心电图常伴多种心律失常,其中以房性心律失常及左束支传导阻滞多见,DCM患者左束支传导阻滞比例偏高。超声心动图结果分析表明,ACM患者以全心增大为著,DCM患者以左房及左室增大为著。ACM患者HDL-C水平明显降低,UA水平明显增高,UA水平随心功能严重程度的增加而有所升高。
[Abstract]:Objective: to compare and analyze the clinical data of patients with alcoholic cardiomyopathy (ACMM) and dilated cardiomyopathy (DCM) in the first affiliated Hospital and the third affiliated Hospital of Zunyi Medical College, and to understand the clinical characteristics of alcoholic cardiomyopathy. Methods: the medical records of patients with ACM and DCM were collected and analyzed from January 2013 to December 2015 in the Department of Cardiology, the first affiliated Hospital and the third affiliated Hospital of Zunyi Medical College. The control group consisted of 40 healthy persons with normal cardiac structure and function. Age, history, electrocardiogram and echocardiography were compared and analyzed among the three groups. The result is 1: 1. A total of 89 patients with ACM were enrolled in the study, including 560men (341 males, 219 females). The ratio of male to female to DCM is 1: 6.290.99, of which 0.35 / 25191% of the total number of patients in cardiology are ACM patients, and the highest percentage of heart function NYHA III grade in ACM group and DCM group is 58.440% 52.42% 59.59.59.590%, respectively. 2. ACM is similar to DCM patients on echocardiography, but ACM patients have the highest proportion of heart function NYHA III grade. 2. The proportion of heart function in ACM patients is similar to that in DCM patients. For 49.4% / 89% DCM patients, the left atrium and left ventricle were enlarged, and the patients with ACM with 69.5% and 389% 560% had various arrhythmias. The most common arrhythmias were atrial arrhythmia and left bundle branch block. However, the percentage of left bundle branch block in DCM group was significantly higher than that in ACM group and DCM group. Compared with the control group, the level of serum triglyceride in the high density lipoprotein cholesterol group was significantly higher than that in the control group, and the UA level was increased with the increase of the severity of NYHA cardiac function grade. Conclusion: the data of recent three years showed that the cardiac function of patients with ACM and DCM had reached NYHA III grade. ACM and DCM patients were often accompanied with multiple arrhythmias in electrocardiogram. Atrial arrhythmia and left bundle branch block were more common in DCM patients. The results of echocardiography showed that the HDL-C level in patients with ACM was significantly decreased with the increase of left atrium and left ventricle. The level of UA was increased with the increase of cardiac function.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R542.2

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