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目的:探讨心肌淀粉样变性(CA)患者的临床特征和预后。方法:回顾性分析19例CA患者的临床资料,对患者的生存影响因素进行相关性和Cox回归分析。结果:19例患者均出现心功能不全表现;肢体导联低电压10例;心脏核磁共振显像心肌呈不同程度延迟强化11例;就诊前有晕厥病史3例;19例患者中死亡9例,平均随访时间(24.2±4.5)个月,1年生存率为67.7%,2年生存率为56.4%,中位生存期为25.1个月。相关性分析表明,患者生存时间与入院时氨基末端B型脑钠肽前体(NT-proBNP)水平、晕厥病史之间存在负相关(r=-0.635,P=0.013;r=-0.632,P=0.002);单因素Cox回归分析,入院时NT-proBNP水平为CA预后的预测指标(P<0.05)。结论:CA预后不佳,生存时间与入院时NT-proBNP水平、晕厥病史密切相关,入院时NTproBNP水平是CA患者预后的预测指标。
Objective: To investigate the clinical characteristics and prognosis of patients with myocardial amyloidosis (CA). Methods: The clinical data of 19 patients with CA were retrospectively analyzed. The correlation between the influential factors and Cox regression analysis was analyzed. Results: All of the 19 patients presented with cardiac insufficiency; 10 cases of low limb lead voltage; 11 cases of myocardial MRI enhancement with delayed enhancement; 3 cases had syncope before treatment; 9 cases died in 19 cases, The average follow-up time was (24.2 ± 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. Correlation analysis showed that there was a negative correlation between the patient’s survival time and the level of NT-proBNP and syncope on admission (r = -0.635, P = 0.013; r = -0.632, P = 0.002). Univariate Cox regression analysis showed that NT-proBNP level at admission was a predictor of prognosis (P <0.05). CONCLUSION: The poor prognosis of CA and survival time are closely related to the level of NT-proBNP on admission and the history of syncope. The level of NTproBNP on admission is a predictor of the prognosis of patients with CA.