摘要目的 扩张型心肌病(DCM)易导致慢性心力衰竭,常合并肺高血压,肺高血压是否为DCM患者预后的危险因素目前尚不清楚.本研究同顾分析了DCM患者的临床基线资料,探讨伴或不伴肺高血压患者的临床特征.方法 回顾性分析2007年1月至2009年12月,住院患者中连续诊断的DCM患者.其中超声诊断伴肺高血压者61例,不伴肺高血压者51例.分析两者入口统计学和基本临床资料、心功能、超声心动图及肝、肾功能等指标的差异.结果 伴肺高血压的DCM患者人口统计学和基本临床资料与不伴肺高血压患者比较差异均无统计学意义.伴肺高血压患者的纽约心功能分级Ⅲ、Ⅳ级者明显多于不伴肺高血压患者(P＜0.01),左心室舒张末径、左心房内径、右心室流出道内径显著大于不伴肺高血压患者[分别为(71.00±9.62) mm比(65.50 ±7.17) mm,( 52.80±8.93) mm比(43.90±6.34 )mm和(29.10 ±5.30) mm比(22.10 ±3.30) mm,P均＜0.01],左心室射血分数显著低于不伴肺高血压患者(0.28 ±0.10比0.36±0.10,P＜0.001),心包积液发生比例明显高于不伴肺高血压患者(29/61比7/51,P ＜0.01),血清胆红素水平显著高于不伴肺高血压患者[(45.30±31.8) μmol/L比(19.50±9.08) μmol/L,P＜0.01],血清肌酐水平两者差异无统计学意义.结论 伴肺高血压的DCM患者心脏扩张较显著,心功能和肝脏功能较差,临床预后可能较差.

abstractsObjective The clinical data of dilated cardiomyopathy (DCM) patients with or without pulmonary hypertension (PH) diagnosed by echocardiography were compared.Methods During January 2007 to December 2009,61 cases of DCM with PH and 51 cases of DCM without PH were admitted in our department.The demographic and clinical data,heart function,echocardiography and serum total bilirubin and creatinine levels of all patients were analyzed.Results Sex,age,vital signs,combined diseases and arrhythmias as well as the serum creatinine level [ ( 103.5 ± 49.7 ) μmol/L vs.( 90.3 ± 37.3 ) μmol/L,P ＞0.05] were similar between the two groups,while the incidence of NYHA Ⅲ and IV (95％ vs.65％ ),the left ventricle end-systolic dimension[ (71.0 ±9.6) mm vs.(65.5 ±7.2) mm],dimension of the left atrium [ (52.8 ±8.93) mm vs.(43.9 ±6.3) mm],right ventricular outflow tract [ (29.1 ±5.3) mm vs.(22.1 ±3.3) mm] incidence of pericardial effusion (29/61 vs.7/51 ) and the serum total bilirubin level [ (45.3 ±31.8) μmol/L vs.(19.5 ±9.08) μmol/L] were significantly higher while ejective fraction was significantly lower in DCM with PH than those in DCM without PH (0.28 ±0.10 vs.0.36 ±0.10,all P ＜0.05 ).Conclusion DCM patients with PH is linked with worse clinical features than DCM patients without PH.