非典型心尖肥厚型心肌病的心电图及超声心动图表现  

The Echocardiographic and Electrocardiographic Features in Patients with Atypical Apical Hypertrophic Cardiomyopathy

作　　者：王树贤[1] 严亦夏[1] 宋成运[1] 

机构地区：[1]中国人民解放军第305医院,北京市100017

出　　处：《中国循环杂志》2000年第3期164-165,共2页Chinese Circulation Journal

摘　　要：目的 :探讨 11例仅心电图异常 T波改变 ,而按冠心病诊治无效患者的病因 ,并评价其预后。　　方法 :对 11例非典型心尖肥厚型心肌病患者 (男 6例、女 5例 )进行心电图、核素心肌断层、踏车运动试验、2 4小时动态心电图、超声影像等检查 ,并与正常人配对比较。　　结果 :11例患者心尖室壁肥厚 ,其舒张期厚度 (平均 1.42± 0 .2 3 cm ) ,与心室间隔基底段舒张期厚度 (1.0 7± 0 .0 7cm )之比为 1.45± 0 .16 ,心尖肥厚组心尖室壁舒张期厚度与正常对照组 (1.0 3± 0 .11cm)比较其差异非常显著 (P<0 .0 1) ,各心腔大小、左心室后壁、左心室收缩及舒张功能正常 ;心电图除 T波异常外无其它异常表现 ,其他各项检查均正常。　　结论 :非典型心尖肥厚型心肌病患者 ,特别是早期病变无特异性临床表现时 ,易漏诊和误治 ,常规测量心尖室壁厚度可指导早期诊断和治疗。Objective:The clinical features of uncomplicated apical hypertrophic cardiomyopathy were assessed. Methods:Physical examination,electrocardiogram,cardiac X ray film,nuclear myocardial perfusion imaging,submaximal echocardiogram(ECG) stress test,24 hour Holter monitoring,2 dimensional echocardiogram were performed in 11 patients (6 males and 5 females) with atypical apical hypertrophic cardiomyopathy and matched normal subjects(control group). Results:The patients had non specific symptoms,marked T wave abnormalities,ineffective to treatment adopted for coronary heart disease.Echocardiographically,the patients exhibited apical hypertrophy(1 42±0 23 cm in thickness,the ratio with interventricular septium was 1 45±0 16,all had significant difference with normal group(1 03±0 11 cm), p <0 01),while other parameters were within normal ranges. Conclusion:Patients with uncomplicated apical hypertrophic cardiomyopathy,especially at the early stage,usually had no marked clinical manifestations other than ECG T wave abnormality which often led to incorrect diagnosis,measuring the thickness of apical myocardium with 2 dimensional echocardiogram is helpful to identify it.

关 键 词：心肌病 心尖肥厚 超声心动图 心电图 

分 类 号：R542.2[医药卫生—心血管疾病] R540.45[医药卫生—内科学]