CAJ | 학술논문

目的通过探讨肥厚型心肌病的特异性超声心动图与心电图表现,提高肥厚型心肌病诊断准确率.方法对2008-2011年北京市顺义区中医医院23例肥厚型心肌病患者行超声心动图检查及标准12导联心电图检查,并对其超声心动图心腔内径、前室间隔厚度、左室流出道内径及观察有无二尖瓣前叶收缩期前向运动(SAM征),血流动力学指标为左室流出道最大血流速度(Vmax)及流速压差(PGmax)等以及对心电图的ST段、T波及QRS波群进行分析.结果 23例肥厚型心肌病患者中心电图出现ST-T改变19例,左心室高电压或左心室肥大15例,心律失常4例(其中心房颤动1例,Ⅰ度房室传导阻滞1例,窦性心动过缓2例),P波高尖1例.肥厚型心肌病患者中超声心动图显示非对称性室间隔肥厚17例(其中左心室流出道梗阻或左心室流出道血流加速者4例),心尖部肥厚型心肌病5例,左有心室壁均肥厚1例.23例肥厚型心肌病超声心动图定量测定:主动脉根部内径(32 ±4)mm,左心房内径(41±7) mm,左心室舒张末期内径(44 ±8)mm,左心室收缩末期内径(27 ±8)mm,前间隔厚度(20±4)mm,左心室后壁厚度(12±2)mm,左心室射血分数(69±12)％.结论超声心动图和心电图检查是目前临床心血管领域中最常用且无创性检查方法,肥厚型心肌病的临床表现多无特异性,超声心动图与心电图联合检查可提高其诊断的准确率.
목적 통과탐토비후형심기병적특이성초성심동도여심전도표현,제고비후형심기병진단준학솔.방법 대2008-2011년북경시순의구중의의원23례비후형심기병환자행초성심동도검사급표준12도련심전도검사,병대기초성심동도심강내경、전실간격후도、좌실류출도내경급관찰유무이첨판전협수축기전향운동(SAM정),혈류동역학지표위좌실류출도최대혈류속도(Vmax)급류속압차(PGmax)등이급대심전도적ST단、T파급QRS파군진행분석.결과 23례비후형심기병환자중심전도출현ST-T개변19례,좌심실고전압혹좌심실비대15례,심률실상4례(기중심방전동1례,Ⅰ도방실전도조체1례,두성심동과완2례),P파고첨1례.비후형심기병환자중초성심동도현시비대칭성실간격비후17례(기중좌심실류출도경조혹좌심실류출도혈류가속자4례),심첨부비후형심기병5례,좌유심실벽균비후1례.23례비후형심기병초성심동도정량측정:주동맥근부내경(32 ±4)mm,좌심방내경(41±7) mm,좌심실서장말기내경(44 ±8)mm,좌심실수축말기내경(27 ±8)mm,전간격후도(20±4)mm,좌심실후벽후도(12±2)mm,좌심실사혈분수(69±12)％.결론 초성심동도화심전도검사시목전림상심혈관영역중최상용차무창성검사방법,비후형심기병적림상표현다무특이성,초성심동도여심전도연합검사가제고기진단적준학솔.
Objective To evaluate the specificity of hypertrophic cardiomyopathy by echocardiography and electrocardiography (ECG).Methods Totally 23 cases of hypertrophic cardiomyopathy had echocardiography examination.Heart cavity diameter,interventricular septum thickness,left ventricular outflow tract inside diameter and anterior mitral valve systolic forward movement (SAM) were observed.Left ventricular outflow tract maximum blood flow velocity (Vmax) and the velocity of the differential (PGmax) were observed.The standard 12-lead electrocardiogram examination was observed.Results Of 23 patients with hypertrophic cardiomyopathy 19 cases had ST-T of ECG change,15 cases had left ventricular high voltage or left ventricular hypertrophy,4 cases had arrhythmia (one case of atrial fibrillation,one case had Ⅰ degree atrioventricular block sinus bradycardia 2 cases),one case had P wave high point.23 cases had hypertrophic cardiomyopathy of ultrasonic echocardiography,17 cases had asymmetry ventricular septal hypertrophy (4 cases had left ventricular outflow tract obstruction or left ventricular outflow blood flow speed),5 cases had apex of hypertrophic cardiomyopathy,one case had left and right hypertrophied chamber.Cardiac aortic root diameter was (32 ± 4) mm ; left atrial diameter was (41 + 7) mm,left ventricular end-diastolic diameter was (44 ± 9) mm ;left ventricular end systolic diameter was (27 ± 8) mnm; the thickness of the left ventricular posterior wall thickness was (12 ± 2)mm; left ventricular ejection fraction was (69 ± 12)％.Conclusion Echocardiography and electrocardiogram are now the most commonly used and noninvasive tests in the field of clinical cardiovascular examination ; the clinical manifestations of hypertrophic cardiomyopathy are not specific and echocardiography and electrocardiogram examination can improve the diagnostic accuracy.