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樊朝美; 李一石; 唐红伟; 陈启明; 蒋文; 黄洁; 刘汉英; 秦王燕; 宁静
中华心血管病杂志, 2001, Volume: 29, Issue: 7Journal Article
R54; 目的评价超声心动图技术在诊断孤立性左室肌致密化不全中的作用.方法 10例孤立性左室肌致密化不全患者,均为男性,年龄2~60(30±17.7)岁.分别采用美国HP-5500及日本Toshiba-140A型二维及多普勒超声心动图仪进行检查,探头频率2.5-3.5MHz.部分患者接受超高速CT或磁共振成像检查.结果 10例患者均有程度不同的左心功能不全、心律失常等临床表现,未见栓塞征象.孤立性左室肌致密化不全超声心动图特征如下:(1)二维超声心动图可见多发性突入心室腔内的肌小梁,且呈节段性分布.好发于左室心尖部、前侧壁;(2)多普勒超声心动图显示深陷于肌小梁隐窝间的血流与左室腔交通;(3)左心室壁呈非均匀性增厚或变薄.10例患者均符合上述诊断标准.2例行超高速CT检查,2例行磁共振成像检查,4例患者均可见左室心尖部、前侧壁肌小梁粗大,左心室腔明显扩大;小梁区心室壁明显增厚.10例患者均因左心功能不全给予常规利尿剂、血管扩张剂及抗凝治疗.结论孤立性左心室肌致密化不全是一种罕见的先天性心肌病,临床上可表现为渐进性左心功能不全、致命性心律失常及栓塞征象.超声心动图是无创诊断孤立性左室肌致密化不全的准确、可靠方法.
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