老年原发性扩张型心肌病与缺血性心肌病的鉴别诊断(附13例冠脉造影分析)  

Differentation of primary dilated cardiomyopathy from ischemic cardiomyopathy in elderly patients (ananalysis of coronary angiography in 13 patients )

作　　者：张萱[1] 李鲁光[1] 肖竞[1] 田军[1] 黄九延[1] 张桂珍[1] 

机构地区：[1]北京军区总医院心内科,100700

出　　处：《中国介入心脏病学杂志》1997年第3期118-119,共2页Chinese Journal of Interventional Cardiology

摘　　要：本文探讨PDCM与ICM的鉴别诊断问题。回顾分析我院1990年2月～1996年12月13例原疑为ICM后经冠脉造影确诊为PDCM患者的临床资料及冠脉造影结果。均有充血性心力衰竭临床表现，年龄60～76岁，均无心肌梗塞史，5例有心绞痛史，均有缺血性ST～T改变，4例有异常Q波。超声心动图均有不同程度的心腔扩大及广泛的室壁运动异常。冠脉造影11例无冠脉狭窄，2例分别有前除支及回旋支20％狭窄。左室造影左室腔均扩大，左室壁及室间隔活动弥漫性减弱，射血分数0．21～0．39。冠脉造影是老年ICM与PDCM鉴别的唯一可靠方法。The differentiation of primary dilated cardiomyopathy (PDCM) from ischemic cardiomy-opathy (ICM ) was evaIuated in this paper. From February 1990 to December 1996, l3 patients with suspected ICM were finally diagnosed PDCM by coronary angiography. The clinical and coronary angio-graphic features of these patients were analyzed restroptively in this paper. All the patients,aging 60-76,had the clinical featers of congestive heart failure with no history of remote myocardio infarction. 5 patients had remote angina Pectoris. Ischemic ST-T changes were observed in all the patients. Abnormal Q-wave was found in 4 patients. Color encoded two dimensional echocardiography showed different degree of enlarged ventricular volume,diffused abnormal ventricular wall movement and lowered left ventricular ejec-tion fraction (0. 33±0. 02). Normal coronary angiography was found in 11 patients,and 20% stenosis of left anterior descending and left circumflex was discovered in two patients respectively. Coronary angiogra-phy is the only way to differentiate PDCM from ICM.

关 键 词：心肌病 扩张型心肌病 缺血性心肌病 鉴别诊断 

分 类 号：R542.204[医药卫生—心血管疾病]