国人Tako—Tsubo心肌病54例临床荟萃分析  

Clinical Meta-analysis of 54 Case with Chinese Tako-Tsubo Cardiomyopathy

作　　者：王军[1] 隋欣桐[1] 孙英贤[1] 王蛟龙[1] 吕岩[1] 庞雪峰[1] 徐峰[1] 

机构地区：[1]中国医科大学附属第一医院心血管内科,辽宁沈阳110001

出　　处：《医学临床研究》2011年第7期1236-1238,共3页Journal of Clinical Research

摘　　要：【目的】总结国人Tako—Tsubo心肌病的临床特点，提高临床医生对该病的认识。【方法】回顾性分析我国54例Tako—Tsubo心肌病的临床资料：【结果】54例患者中，87％为女性，其中38例（70．4％）为绝经后女性，平均年龄（60．3±13．8）岁；74．1％的患者在发病前有应激因素；主要首发症状为胸痛（72．2％）和胸闷（55．6％），其他伴随症状包括：大汗、心悸、恶心呕吐等。83．3％患者入院的心电图表现为ST段抬高。大部分患者的肌钙蛋白及CK—MB仅轻度升高。影像学检查：大部分患者冠脉造影正常，左心室造影及心脏超声表现为收缩期左心室心尖部呈球样改变，基底部室壁运动代偿性增强。【结论】作为急性心肌梗死的鉴别诊断，Tako—Tsubo心肌病应当受到关注。当出现下列情况时：绝经后女性、发病前有严重的心理或躯体应激等诱发因素、与病情不相符的心电图及心肌酶学改变，应高度警惕Tako—Tsubo心肌病的可能。心脏超声、冠状动脉造影和左心室造影检查是鉴别诊断的有力依据。[Objective]To summarize the clinical features of Chinese Tako-Tsubo cardiomyopathy in order to improve the clinical physician＇s cognition of the disease. [Methods] The clinical data of 54 cases of Chinese Tako-Tsubo cardiomyopathY were analyzed retrospectively. [Results]About 87% of 54 eases were female in which 38 cases（70.4%） were postmenopausal women. The mean age was （60. 3± 13.8） years old. About 74.1% of patients were related to psychological stressful factors before the onset of the disease. The initial symptoms were chest pain（72.2 %） and chest stuffiness（55.6 % ）. Other concomitant symptoms included profuse sweating, palpitation, nausea and vomiting. The admission electrocardiogram changes of 83.3% of patients were ST-segment elevation. The troponin and CKvMB of most patients were only slightly elevated. The coronary artery angiographies of most patients were normal. The typical changes of left ventricular angiography and color Doppler echocardiography were balloon-like change of systolic left ventricular apex and compensatory augmentation of basal ventricular wall motion. [Conclusion] Tako-Tsubo cardiomyopathy should be considered as a differential diagnosis of acute myocardial infarction. When the following conditions appears.. postmenopausal women, psychological or physical stressful factors before the onset Of the disease, inconsistent electrocardiogram and cardiac enzyme changes, the possibility of Tako-Tsubo cardiomyopathy should be paid highly attention. Color Doppler echocardiography, coronary artery angiography and left ventrieular angiography are the strong basis for differential diagnosis.

关 键 词：心肌疾病 

分 类 号：R542.2[医药卫生—心血管疾病]