小儿左冠状动脉起源于肺动脉临床分析  

Clinical analysis of 8 children with anomalous origin of the left coronary artery from the pulmonary artery

作　　者：邵魏[1] 袁越[1] 张永兰[1] 高路[1] 刘颖中[1] 

机构地区：[1]北京首都医科大学附属北京儿童医院心脏中心,100045

出　　处：《心肺血管病杂志》2010年第4期284-286,共3页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:总结小儿左冠状动脉起源于肺动脉(ALCAPA)的临床特点,提高对ALCAPA的认识。方法:对2006年8月至2008年12月期间我院心脏中心门诊以"心内膜弹力纤维增生症"收治但最终诊断为ALCAPA的8例患者的临床特点、检查情况进行回顾性分析。结果:8例ALCAPA的患者女性7例,男性1例。发病年龄2～10个月,平均年龄5.3个月。8例患者均表现不同程度的气促、喘息、声哑、多汗及喂养困难等心力衰竭(心衰)症状。病初均于首诊医院误诊为心内膜弹力纤维增生症。患儿心电图、心脏超声及心脏增强CT均有较为特征性的改变。结论:小儿ALCAPA病例临床常易与心内膜弹力纤维增生症混淆。对于临床诊断心内膜弹力纤维增生症的患儿应注意其心电图表现。其中符合ALCAPA心电图特点的病例,反复探查其心脏彩超并进行心脏增强CT、心脏冠状动脉造影检查有助于ALCAPA的诊断。Objective：To summarize clinical manifestations of children with anomalous origin of the left coronary artery from the pulmonary artery（ALCAPA） and improve knowledge of ALCAPA. Methods：To analyze clinical manifestations and examination findings of children with ALCAPA who had been diagnosed in Beijing Children’s Hospital from Aug. 2006 to Dec. 2008. All of the patients had been diagnosed as endocardial fabroelastosis first. Results：Eight children with ALCAPA aged from 2 months to 10 months（median 5. 3months）. All the patients represent symptom of heart failure such as shortness of breath,wheeze,hoarseness,diaphoresis, feed failure etc. those pantients had been diagnosed as endocardial fabroelastonsis first. Patients with ALCAPA have characteristic findings at electrocardiogram（ ECG）,echocardiogram,computerized tomography. Conclusions：＂ALCAPA＂and＂endocardial fabroelastosis＂are a source of confusion in clinical diagnose. We should pay more attention at patients who had been diagnosed as endocardial fabroelastosis in ECG finding. Patients whose ECG finding are similar with ALCAPA should take more check such as echocardiogram,computerized tomography,DSA examination which are helpful to the diagnosis of ALCAPA.

关 键 词：左冠状动脉起源于肺动脉 先天性心脏病 诊断 

分 类 号：R541.1[医药卫生—心血管疾病]