超声心动图对心肌淀粉样变性的诊断价值  

The value of echocardiography in the diagnosis of cardiac amyloidosis

作　　者：苏春晓[1] 吴棘[1] 蒋春兰[1] 陈辉[1] 郭盛兰[1] 覃诗耘[1] 

机构地区：[1]广西医科大学第一附属医院超声科,南宁530021

出　　处：《广西医科大学学报》2017年第7期971-973,共3页Journal of Guangxi Medical University

基　　金：广西自然科学基金资助项目(No.2013GXNSFAA019173);广西科学研究与技术开发计划基金资助项目(No.1298003-3-1)

摘　　要：目的:分析心肌淀粉样变性(CA)的临床特点及无创性诊断方法,探讨超声心动图对CA的诊断价值。方法:选取2012年10月至2016年12月广西医科大学第一附属医院收治的28例疑似CA患者作为研究对象,其中经心外活检确诊8例(CA1组),临床及超声心动图高度怀疑20例(CA2组);同时选取20例健康体检者为正常对照组,分析各组临床表现、心电图、超声心动图、心脏磁共振表现等特点。结果:CA1组、CA2组患者的临床表现及心电图表现均无特异性。CA1组、CA2组患者超声心动图均有室间隔与左室壁向心性肥厚及心肌"闪耀征"的典型表现。超声心动图指标分析显示,CA1组较正常对照组室间隔厚度(IVS)、左室后壁厚度(LVPW)、左房横径(LATD)增加,左室舒张内径(LVDD)减低;CA2组较正常对照组IVS、LVPW、左房内径(LAD)、LATD增加,LVDD、左室射血分数(LVEF)减低;CA1组较CA2组LAD减低、LVEF增加,以上差异均有统计学意义(均P<0.05)。结论:CA的临床表现缺乏特异性,病理活检又难以常规开展,超声心动图能直接显示CA患者心脏形态、回声的典型改变,评估其舒缩功能,对疾病诊断及预后评估具有重要的临床价值。Objective： To analyze the clinical characteristics and noninvasive diagnosis methods ot cardiac amyloidosis （CA） and the diagnostic value of echocardiography on CA. Methods： 28 patients suspected with CA in our hospital from October 2012 to December 2016 were selected. 8 cases confirmed by biopsy were defined as CA1 group, and 20 cases highly suspected with CA by clinical characteristics and echocardiography were defined as CA2 group. 20 healthy subjects were selected as the control group. The clinical characteristics, electrocardiogram, echocardiography and MRI were analyzed. Results： Compared with the control group, the interventricular septal （IVS） thickness, left ventricular posterior wall （LVPW） thickness and left atrium transverse diameter （LATD） increased, while left ventricular end-diastolic diameter （LVDD） decreased in CA1 group （P〈0.05）. The IVS, LVPW, left atrial diameter （LAD） and LATD increased, while LVDD and left ventricular ejection fraction （LVEF） decreased in CA2 （P〈0. 05）. The LAD was lower in CA1 group than that in CA2 group, whereas the LVEF was higher （P〈0.05）. Conclusion.The clinical manifestations of CA were lack of specificity, and the pathological biopsy was difficult to carry out routinely. Echocardiography could visually display the cardiac structure and echo changes and assess their diastolic and systolic function. Therefore, it is of important clinical value for diagnosis and prognosis evaluation of CA.

关 键 词：心肌淀粉样变性 临床特点 组织活检 超声心动图 

分 类 号：R445.1[医药卫生—影像医学与核医学]