淀粉样变致限制型心肌病的心电学特征分析  

Analysis of the cardiac electrical characteristics in patients with restrictive cardiomyopathy secondary to amyloidosis

作　　者：孙敏丽[1,2] 李小荣[1] 陈椿[1] 单其俊[1] 陈明龙[1] 曹克将[1] 

机构地区：[1]南京医科大学第一附属医院心脏科,江苏南京210029 [2]江苏省滨海县人民医院心内科,江苏滨海224500

出　　处：《中国心脏起搏与心电生理杂志》2016年第6期509-512,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：国家自然科学基金(81400253);江苏省自然科学基金(BK20141029);国家"十二五"科技支撑计划项目(2011BAI11B13);江苏高校优势学科建设工程

摘　　要：目的探讨分析继发于淀粉样变的成人限制型心肌病（RCM）的心电学特征。方法收集2013年1月1日至2015年12月31日入住本院且诊断为继发于淀粉样变的成人RCM患者病历资料,所有患者行心电图检查,部分行24h动态心电图检查,分析心电图特征及心律失常发生情况。结果共纳入16例成人RCM患者[55.00±14.20（19~74）岁],62.5%的患者为男性（10例）。心电参数分别为PR间期（180.80±44.28）ms,QRS间期99.50（87.50,108.75）ms,QT间期395.00（378.75,455.00）ms,QTc间期（447.10±43.02）ms。68.75%的患者表现为肢体导联低电压,肢体导联最大电压为（0.45±0.21）mV。93.75%的患者胸导联R波递增不良。所有患者心电图均出现了非特异性的T波低平倒置等改变（100%）。87.50%的RCM患者可见心律失常,主要表现为房性心律失常（37.50%）、窦性心动过缓（25.00%）、非持续室性心动过速（25.00%）、一度房室传导阻滞者（12.50%）、室性早搏（12.50%）、交界性心动过速（12.50%）。结论 RCM具有较为独特的心电学特征,可为临床诊断提供一定的线索与依据。Objective To explore the cardiac electrical characteristics of restrictive cardiomyopathy（RCM）secondary to amyloidosis in adult patients. Methods The ECG related parameters and arrhythmia occurrence of patients diagnosed as RCM secondary to amyloidosis were collected and analyzed,patients were enrolled in our hospital from January 1,2013 to December 31,2015.All of them received ECG and part of patients received Holter. Results Totally,there were 16 cases of adult RCM patients[19-74 years,mean（55.00±14.20）years],62.5% of the patients were male（10cases）.PR interval of ECG was（180.80 ±44.28）ms,QRS duration was 99.50（87.50,108.75）ms,QT interval was 395.00（378.75,455.00）ms,QTc was（447.10±43.02）ms.68.75% of the patients showed a low QRS voltage in limb leads,the maximum QRS voltage of limb leads was（0.45±0.21）mV.93.75%patients had the poor R wave progression in chest lead.All patients had different degrees of inverted or flat T-wave.Mainly,the arrhythmias were atrial arrhythmia（37.50%）,sinus bradycardia（25.00%）,non-sustained ventricular tachycardia（25.00%）,1st degree of atrioventricular block（12.50%）,premature ventricular contractions（12.50%）and junctional tachycardia（12.50%）. Conclusion RCM patients have a relatively unique characteristics of cardiac electrical characteristics,which can provide clues and evidence for the clinical diagnosis.

关 键 词：心血管病学 限制型心肌病 淀粉样变 心电学特征 

分 类 号：R542.2[医药卫生—心血管疾病] R540.41[医药卫生—内科学]