摘要
目的探讨心尖肥厚型心肌病超声诊断特点及预后随访。方法对27例心尖肥厚型心肌病患者心电图、超声心动图进行1～13年（平均5．2年）随访观察。结果27例患者心电图胸前导联异常T波深置，V3-5导联最为显著，重者出现巨大倒置T波≥10mm，胸前导联R波振幅V4〉V5〉V3，超声心动图显示心尖部明显增厚15～37（18．0±3．3）mm，末次随访心尖部厚度（19．7±3．7）mm，左室心尖部厚度与左室后壁厚度比值分别为1．7±0．3和1．9±0．9，随访前后比较差异有统计学意义（P〈0．05），但左室舒张末期内径及左室射血分数随访前后未见显著差异。主要心血管事件为心房颤动，心功能Ⅲ～Ⅳ级，前壁心肌梗死及心脏猝死。结论心尖肥厚型心肌病主要依据心电图胸前导联T波深置及超声心动图心尖肥厚特点作出诊断，该病进展缓慢，一般临床预后较好。
Objective To evaluate the echocardiographic features of apical hypertrophic cardiomyopathy（ApHCM）. Methods Twenty-seven patients with ApHCM including 21 men and 6 women, average age （42. 7 ±5.1 ） years old were followed up from 1995 to 2008 to investigate the clinical, electrocardiographic and echocardiographic features. Results The major features of ECG were increased R amplitude（ V4 〉 V5 〉 V3 ）and inverteted T wave（ especially in V34 leads and the voltage of the inverteted T waves may be up to 〉/10 mm）. The major feature of echocardiography was the thickening of left ventricular apical wall to 15 -37 （18.0 ±3.3 ）mm. The final follow up showed that the mean thickness of the apical wall was （19.7±3.7 ）ram. The ratio of the thickness of left ventricular apical wall to posterior wall before and after the follow up was 1.7 ±0. 3 and 1.9 ± 0.9 respectively, with significant statistical difference （ P 〈 0. 05）. There was no difference in the left ventricular end-diastolic dimension and left ventricular ejection fraction. The main cardiovascular events were atrial fibrillation （ 16 cases）, heart failure of NYHA Ⅲ-Ⅳ class （3 cases） , anterior wall myocardial infarction （1 case） and sudden death （1 case）. Conclusions The final diagnosis of ApHCM depends on the characteristic inverteted T wave in ECG and apical hypertrophy in echocardiography. The prognosis of ApHCM is rather good for its progression is relatively slow.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2010年第2期119-121,共3页
Chinese Journal of Internal Medicine
关键词
心肌病
肥厚性
超声心动描记术
随访研究
Cardiomyopathy, hypertrophic
Echocardiography
Follow-up studies
