摘要
目的：比较分析致心律失常性右心室心肌病（ARVC）无创性诊断方法的阳性率及特征。方法：选择从2008—08至2010—05于我院诊断为ARVC的患者64例。分析比较其心电学、超声心动图及磁共振成像诊断标准的阳性率及特征。结果：64例中男性47例，女性17例，确诊年龄为（35．5±13．4）岁。63例（98．4％）临床症状为心悸，14（21．9％）例患者发生晕厥，3例有ARVC家族史。64例患者均记录到心电图异常，其中52例（81．3％）患者记录到室性心动过速（VT），38例（59．4％）为右心室室性心动过速；25例（39．1％）患者频发室性期前收缩；2例患者发生心室颤动。窦性心律心电图特征性表现包括：①37例（57．8％）存在主要在右胸导联的T波倒置（V1、V2、V3）；②18例（28．1％）可见Epsilon波；③23例（35．9％）患者v1。3导联QRS平均时程≥110ms，大于左胸导联；④22例（34．4％）有右束支传导阻滞。48例（75．0％）患者磁共振成像检查阳性，其中4例患者磁共振成像检查显示累及左心室。18例（28．1％）超声心动图检查显示阳性。心电异常及磁共振成像检出结果阳性率显著高于超声心动图，P〈0．05。结合超声心动图与心电学检查能提高诊断符合率。结论：ARVC患者常见的心律失常包括室性心动过速及频发室性期前收缩，未出现Epsilon波患者合并室性心动过速、心室颤动与累及左心室的比例较高，但差异无统计学意义。心电异常及磁共振成像检查阳性率高于超声心动图，磁共振成像显示ARVC亦能累及左心室。
Objective： To compare and analyze the features for noninvasive and positive diagnosis in patients with arrhythmogenic right ventricular cardiomyopathy （ARVC）. Methods： We retrospectively studied 64 ARVC patients diagnosed in our hospital from August 2008 to May 2010. The patients included 47 male and 17 female with the diagnosed age of （35.5 ±134） years. We compared the positive diagnostic rate and features of ARVC by electrocardiography （ECG）, ultrasound cardiogram （UCG） and magnetic resonance imaging （MRI） respectively. Results： There were 63 （98.4%） patients with palpitation, 14 （21.9%） experienced syncope and 3 with family history of ARVC. By ECG examination, all patients presented abnormal findings, 52 （81.3%） cases with ventricular tachycardia （VT）, 38 （59.4%） with VT from right ventricular origin, 25 （39.1%） with frequent ventricular premature beats and 2 with ventricular fibrillation. The sinus rhythm ECG included ① 37 （57.8%） cases of T-wave inversion mainly in the precordial leads in Vl -V3.② 18 （28.1%） of Epsilon waves. ③ 23 （35.9%） with QRS duration ≥ 110 ms in VI-V3 which were longer than those in left leads. ④ 22 （34.4%） with right ventricular bundle branch block （RBBB）. By MRI examination, there were 48 patients （75%） with positive results and 4 of them showed left ventrieular involvement. By UCG examination, 18 patients （28.1%） had positive results. ECG and MRI indicated more positive diagnostic rate than that of UCG, P〈0.05, while combining ECG with UCG may increase the diagnostic coincidence rate. Conclusion： The common arrhythmia of ARVC including VT and frequent ventrieular premature beats, the patients without Epsilon wave had more chances combining VT, ventrieular fibrillation and left ventricle involvement. MRI and ECG had higher positive diagnostic rate than UCG.
出处
《中国循环杂志》
CSCD
北大核心
2013年第5期330-333,共4页
Chinese Circulation Journal
关键词
心律失常性右心室心肌病
心电图
超声心动图
磁共振成像
Arrhythmogenic right ventricular cardiomyopathy
Electrocardiography
Ultrasound cardiogram
Magneticresonance imaging
