心尖肥厚型心肌病的超声心动图诊断价值  

Diagnostic Value of Apical Hypertrophic Cardiomyopathy with Echocardiography

作　　者：贾冬林[1] 祝晓东[1] 杜英[2] 

机构地区：[1]中日友好医院超声诊断科,北京市100029 [2]中日友好医院心电图室,北京市100029

出　　处：《中国超声医学杂志》2002年第7期547-549,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 :探讨超声心动图检测心尖肥厚型心肌病 (AHCM)的特征性改变和诊断价值。方法 :16例 AHCM患者和 30例正常对照组用超声心动图、心电图检测 ,其中 5例进行了冠状动脉造影及左室造影检查。结果 :16例AHCM患者超声心动图检测左室心尖部厚度与正常组比较有显著差异 (18.6± 5 .1) mm VS (0 .85± 0 .0 8mm ) ,P<0 .0 5。左室重量增加与正常组比较有显著差异 (2 0 3.8± 5 0 .6 ) g VS (135 .0± 2 6 .0 ) g,P<0 .0 5。左房径增大与正常组比较有显著差异 ,(39.0± 5 .7) mm VS (30 .6± 2 .9) mm,P<0 .0 5 )。本组 16例中除 8例心尖肥厚同时累及室间隔中下段以外 ,其他 8例为对称性局限性心尖部肥厚。 5例冠状动脉造影正常 ,左室造影均显示心尖部心肌肥厚呈黑桃征。胸前导联心电图显示巨 T波倒置 ,R波振幅增高。结论 :超声心动图是准确诊断 AHCM的主要方法之一 ,能够为临床提供有价值的诊断依据。Objective:To evaluate the clinical importance of echocardiography in diagnosis of apical hypertrophic cardiomyopathy (AHCM).Methods:Sixteen patients with AHCM and 30 normal subjects were examined by echocardiography and ECG, and 5 patients were examined by coronary angiography and left ventriculography.Results:Left ventricular apex thickness in AHCM group were significant different compared with normal group (18 6±5 1mm VS 0 85±0 08mm, P <0 05).Left ventricular mass were significant different compared with normal group (203 8±50 6g VS 135 0±26 0g, P <0 05).Left atrial dimension increase were significant different compared with normal group (39 0±5 7mm VS 30 6±2 9mm, P <0 05). Echocardiographic images indicated the hypertrophied myocardium was confined to a narrow region of the septum or the anterior or lateral wall at the apical level. Coronary angiography and left ventriculography demonstrated apical hypertrophic cardiomyopathy with normal coronary angiogram in 5 patients. ECG showed giant T wave inversion and increase of R amplitudes in chest leads.Conclusions:Echocardiography is an accurate and effective method for diagnosis of apical hypertrophic cardiomyopathy.

关 键 词：心尖肥厚型心肌病 超声心动图 诊断 

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