摘要
目的:探讨心尖肥厚型心肌病(AHCM)的临床特点及心电图、超声心动图的特征.方法:回顾性分析15例AHCM患者的临床症状和体征、生化及放射学检查结果、冠状动脉造影和心室造影结果,尤其是心电图和超声心动图的特征.结果:15例AHCM患者临床症状轻轻微或缺如,心脏体征无特异性,生化检查大致正常,全部病例冠状动脉造影正常,心室造影有5例左心室舒张末期呈'黑桃'样改变.心电图的主要表现为:胸前导联(V2～V6)及以R波为主的标准导联、加压单极肢导联(如aVL)T波倒置(0.3～1.7mV),且以V3、V4导联T波倒置最为明显;上述导联ST段压低(0.1～0.3mV);V1～V3导联R波振幅明显增高;所有病例均无异常Q波.超声心动图检查左室心尖部(乳头肌水平以下)肥厚,最厚处可达28mm.结论:AHCM的诊断应主要依靠心电图及超声心动图的特征性改变来确定,磁共振检查对确诊AHCM有重要价值.
Objective： To investigate the clinical feature, electrocardiographic and echocardiogrphic characteristics of apical hypertrophic cardiomyopathy （AHCM）. Methods： The clinical signs and symptoms, biaochemical and radiological results, coronary arteriongraphy and ventriculography results, especial about electrocardiographic and echocardiogrphic characteristics of 15 AHCM were retrospectively reviewed. Results： The clinical symptoms of 15 cases AHCM was little or absence, the physical sign of heart was no specificity, the biochemistry and coronary arteriongraphy results were basically normal, only 5 cases in ventriculography had the apical ＂spade＂ changes. ECG showed T wave inversion （0.3-1.7mV） in V2-V6 and aVL leads, especially in V3 and V4 lead; ST-segment depression in above leads （0.1-0.3mV）; R wave amplitude in V1-V3 lead increased obviously; and abnormal Q wave was not observed in all cases. ECHO showed left ventricular apex hypertrophy, and the thickness may reach 28mm at most. Conclusions： The diagnosis of AHCM should depend on diagnostic changes of electrocardiogram and echocardiogram, and magnetic resonance has important value in diagnosing AHCM.
出处
《承德医学院学报》
2005年第3期207-209,共3页
Journal of Chengde Medical University
关键词
心肌病
心尖肥厚
心电描记术
超声心动描记术
Cardiomyopathy
Apical hypertrophy
Electrocardiography
Echocardiography
