摘要
目的探讨心尖肥厚型心肌病（AHCM）的临床表现，心电图特点、冠状动脉造影（CAG）结果和长期预后情况。方法对53倒经超声心动图确诊的AHCM患者，进行病史回顾，体格检查、心电图和CAG检查，并通过电话和门诊随访，了解心血管事件发生情况。结果AHCM患者病史不典型，但心电图有特征性变化，表现为胸前导联巨大倒置T波，尤其以V4导联显著，伴有ST段下移，常被误诊为冠心病。30例行CAG者中28例示左冠状动脉明显增粗；3例发现器质性狭窄，并成功置入支架；7例发现心肌桥，均位于左前降支。经0．4～7．5年的随访，仅1例死于癌症。结论AHCM有比较典型的心电图表现，左冠状动脉内径增粗，常并发肌桥和冠心病，远期预后较好。
Objective To explore the clinical manifestations, ECG characteristics,coronary angiography resultsand long--term prognosis of apical hypertrophic cardiomyopthy （AHCM）.Method：Fifty--three patients with AH--CM ,confirmed by ultrasound cardiography, were received history review, physical examinations, ECG tests, and/or coronary angiography. Long--term follow--up was conducted by telephone or at outpatients＇ room to ascertain the incidence of cardiovascular events. Result：The history of AIICM was not typical, but its ECG had characteristic changes, which showed great inverted T wave with ST segment depression at precordial leads, especially at V41cad. It was usually misdiagnosed as coronary heart disease, especially non--Q wave myocardial infarction. Among30 patients undergoing coronary angiography, 28 patients showed large left coronary arteries, while 3 patients hadsignificant stenotic lesion and then received successful stenting. Myocardial bridge was found in 7 patients. Duringthe follow--up period of 0·4-7·5 years, only I patients died of cancer.Conclusion：AHCM has typical ECG changeswith large left coronary arteries and good long-term prognosis, usually coexisting with myocardial bridges and coronary heart disease.
出处
《中外医疗》
2008年第5期21-22,共2页
China & Foreign Medical Treatment
关键词
心肌病
肥大型
心电描记术
冠状动脉造影
预后
Cardiomyopathy, apical hypertrophy
Electrocardiography
Coronary angiography
Prognosis
