超声心动图联合心电图对致心律失常性右室心肌病的诊断价值  

Diagnostic value of echocardiography combined with electrocardiogram for arrhythmogenic right ventricular cardiomyopathy

作　　者：周敏[1,2] 雍永宏[1] 姬后亮[2] 刘剑秋 高翔[2] 舒开凤 ZHOU Min;YONG Yong-hong;JI Hou-liang;LIU Jian-qiu;GAO Xiang;SHU Kai-feng(Department of Cardiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Function,Nanjing Pukou Hospital of TCM,Nanjing 211800,China)

机构地区：[1]南京医科大学第一附属医院心脏科,南京210029 [2]南京市浦口区中医院功能科,南京211800

出　　处：《医疗卫生装备》2018年第9期56-59,共4页Chinese Medical Equipment Journal

基　　金：江苏省人力资源和社会保障厅2015年度"六大人才高峰"D类资助项目(2015-WSN-037)

摘　　要：目的:探究超声心动图联合心电图对致心律失常性右室心肌病(arrhythmogenic right ventricular cardiomyopathy,ARVC)的诊断价值,为疾病诊断及治疗方案的制订提供依据。方法:选取2015年9月至2017年10月经心内膜活检证实的39例ARVC患者作为研究对象,均行超声心动图与心电图检查,对超声心动图与心电图的主要表现进行统计分析,并比较超声心动图联合心电图诊断与超声心动图、心电图单一方法诊断ARVC的阳性率。结果:超声心动图主要表现为右室增大(89.74%)、右室肌小梁紊乱(76.92%)、右室流出道增宽(66.67%)、右室壁弥漫性变薄(66.67%)、右房增大(51.28%)等;心电图主要表现为V1~V3导联QRS波增宽超过110 ms(69.23%)、V1~V3导联T波倒置(61.54%)、出现Epsilon波(35.90%)。应用超声心动图联合心电图诊断的阳性率为89.74%,均高于心电图(阳性率66.67%)、超声心动图(阳性率30.77%)单一诊断,差异有统计学意义(P<0.05)。结论:超声心动图联合心电图诊断可明显提高ARVC诊断阳性率,减少漏诊,为临床制订早期防治方案提供可靠依据。Objective To investigate the value of echocardiography combined with electrocardiogram in the diagnosis of arrhythmogenic right ventricular cardiomyopathy, and to provide the basis for the diagnosis and treatment of disease.Methods Totally 39 patients with arrhythmogenic right ventricular cardiomyopathy（ARVC） in the hospital from September2015 to October 2017 were selected as the subjects. Echocardiography and ECG examinations were performed in the two groups. The characteristics of echocardiography and EGG were counted. The diagnosis positive rate of ARVC by echocardiography and ECG was compared with that by ECG only. Results The echocardiography of 39 cases showed right ventricular enlargement in 35 ones（89.74%）, right ventricular trabecular disorder in 30 ones（76.92%）, right ventricular outflow tract dilatation in 26 ones（66.67%）, right ventricular wall diffuse thinning in 26 ones（66.67%） and right atrial enlargement in 20 ones（51.28%） etc. The electrocardiogram mainly showed V1 to V3 leads QRS wave width over 110 ms in27 cases（69.23%）, V1 to V3 leads T wave inversion in 24 ones（61.54%）, Epsilon wave in 14 ones（35.90%） etc. The positive rate of ARVC diagnosed by echocardiography combined with ECG was 89.74%, which was significantly higher than that by only ECG（66.67%） or by echcardiography（30.77%）（P〈0.05）. Conclusion Echocardiogra-phy combined with ECG examination can significantly improve the diagnostic positive rate of arrhythmogenic right ventricular cardiomyo-pathy,reduce the missed diagnosis, and provide a reliable basis for the early prevention and treatment plan.

关 键 词：ARVC 超声心动图 心电图 诊断阳性率 漏诊 

分 类 号：R318[医药卫生—生物医学工程] R540.41[医药卫生—基础医学]