本文選題：心肌病　切入點：心肌淀粉樣變性　出處：《臨床心血管病雜志》2017年02期

【摘要】：目的:探討心肌淀粉樣變性(CA)患者的臨床特征和預(yù)后。方法:回顧性分析19例CA患者的臨床資料,對患者的生存影響因素進行相關(guān)性和Cox回歸分析。結(jié)果:19例患者均出現(xiàn)心功能不全表現(xiàn);肢體導(dǎo)聯(lián)低電壓10例;心臟核磁共振顯像心肌呈不同程度延遲強化11例;就診前有暈厥病史3例;19例患者中死亡9例,平均隨訪時間(24.2±4.5)個月,1年生存率為67.7%,2年生存率為56.4%,中位生存期為25.1個月。相關(guān)性分析表明,患者生存時間與入院時氨基末端B型腦鈉肽前體(NT-proBNP)水平、暈厥病史之間存在負(fù)相關(guān)(r=-0.635,P=0.013;r=-0.632,P=0.002);單因素Cox回歸分析,入院時NT-proBNP水平為CA預(yù)后的預(yù)測指標(biāo)(P0.05)。結(jié)論:CA預(yù)后不佳,生存時間與入院時NT-proBNP水平、暈厥病史密切相關(guān),入院時NTproBNP水平是CA患者預(yù)后的預(yù)測指標(biāo)。
[Abstract]:Objective: to investigate the clinical features and prognosis of patients with myocardial amyloidosis (CAA). Methods: the clinical data of 19 patients with CA were analyzed retrospectively. The correlation of survival factors and Cox regression analysis were carried out. Results all 19 cases had cardiac insufficiency, 10 cases had low voltage in limb lead, 11 cases had delayed enhancement of cardiac muscle in different degree by magnetic resonance imaging (MRI), 10 cases had low voltage in limb lead, 11 cases had delayed enhancement of myocardium in different degree by nuclear magnetic resonance imaging. Of the 19 patients with history of syncope before treatment, 9 died, with an average follow-up time of 24.2 鹵4.5 months. The 1-year survival rate was 67.7, the 2-year survival rate was 56.4 and the median survival time was 25.1 months. There was a negative correlation between survival time and NT-proBNPs at admission and history of syncope. Univariate Cox regression analysis showed that NT-proBNP level at admission was a predictor of prognosis of CA. The survival time was closely related to the NT-proBNP level at admission and the history of syncope. The NTproBNP level at admission was a predictor of the prognosis of CA patients.
【作者單位】： 電子科技大學(xué)附屬四川省人民醫(yī)院心內(nèi)科;成都醫(yī)學(xué)院體溫與炎癥四川省高校重點實驗室;
【分類號】：R542.2

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