致心律失常性右室心肌病的临床及超声心动图特点  

Clinical and Echocardiographic Characteristics of Arrhythmogenic Right Ventricular Cardiomyopathy

作　　者：刘薇[1] 崔丽峰[2] 

机构地区：[1]临沂市人民医院超声诊疗中心,山东省临沂市276003 [2]临沂市人民医院心内科,山东省临沂市276003

出　　处：《中国超声医学杂志》2007年第5期388-390,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨致心律失常性右室心肌病(ARVC)的临床和超声心动图特点。方法收集、查阅1993年～2005年我院心内科7例诊断为ARVC的入院病例资料,分析其临床资料及超声心动图特点。结果7例ARVC患者中6例以室性心律失常发病,1例为家系检查时发现。1例猝死,1例心力衰竭,4例晕厥,1例无症状。所有患者均做了心电图、二维超声心动图,部分患者做了动态心电图、心室核素造影、右心室造影。二维超声心动图检查:所有患者均有右心室扩大,4例右室流出道扩张,1例左室略大;5例右室壁运动弥漫性减弱,2例局限性减弱,2例右室室壁瘤形成,3例室间隔运动异常;所有患者三尖瓣、肺动脉瓣口前向血流速度均减慢,右房内均见反流束,反流压差均较低。结论(1)ARVC患者的临床表现较为复杂多样,典型者常以反复发作性室性心动过速、晕厥、猝死为其首发症状;部分呈家族遗传倾向;(2)超声心动图显示有右心室扩大、右室流出道扩张伴右心室壁弥漫性或局限性变薄、动度减弱,部分患者左心室受累;(3)超声心动图简便、易行,但在诊断ARVC时需除外其他致右室扩大的病变。Objective We reviewed the clinical and echocardiographic features of arrhythmogenic right ventricular cardiomyopathy （ARVC） in order to improve the diagnostic accuracy of ARVC. Methods The clinical data from 7 confirmed ARVC patients were collected and analyzed. Results Six of the seven patients presented ventricular arrhythmogenic attack and one was found in his family medical check-up. One patient had sudden death; four patients had syncope; one right heart failure and one no obvious symptom. All patients underwent 2-dimensional echocardiography （2-DE）. Holter monitoring, emission computerized tomography （ECT） and right ventricular angiocardiography were performed in some patients when necessary. 2-DE showed that all the patients had enlarged right ventricle; four patients had dilated right ventricular outflow tract. Four patients had depressed right ventricular activity and two had right ventricle aneurysm formation. The movements of interventricular septum were abnormal in 3 cases and the left ventricle was involved in 1. The forward flows of tricuspid orifice and pulmonary orifice were slower than that of the normal in all patients. All cases had mild-moderate regurgitation of tricuspid valve with lower pressure gradient. Conclusions （1） ARVC patients had various symptoms. The common symptoms included recurrent ventricular tachycardia, syncope and sudden death. There is a familial hereditary tendency. （2） Right ventricle/right ventricular outflow tract was dilated and acompanied with reduced right ventricular contractive activity. Right ventricular aneurysm was formed in some patients. The left ventricle may be involved in some patients, （3） Two-dimensional echocardiography is a simple and feasible modelity for diagnosing ARVC, but other causes of dilated right ventricle should be ruled out.

关 键 词：超声心动图 临床 诊断 致心律失常性右心室心肌病 

分 类 号：R542.2[医药卫生—心血管疾病]