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-  2018 

造影超声心动图评价肥厚型心肌病左室下壁肥厚的应用价值

DOI: doi:10.7507/1001-5515.201707053

Keywords: 肥厚型心肌病, 造影超声心动图, 下壁肥厚

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Abstract:

本研究旨在探讨造影超声心动图(CEcho)评价肥厚型心肌病(HCM)左室下壁肥厚的价值。选取 2015 年 5 月至 2016 年 10 月在四川大学华西医院诊断的 HCM 患者 114 例,均行常规超声心动图(Echo)和 CEcho 检查,其中 45 例行心脏磁共振检查(CMR),47 例行动态心电图(Holter)检查。分析 HCM 患者中左室下壁肥厚发生的频次及其所占的比例,并进一步探索 HCM 伴下壁肥厚患者心脏结构及功能变化。结果显示:(1)CEcho 对 HCM 患者下壁肥厚的检出率为 60%,较 Echo 检出率(48%)明显增高。(2)与金标准 CMR 对比,CEcho 测量下壁基底段及中段舒张及收缩末期厚度无明显差异,但有增高的趋势;Echo 测值低于 CMR(P < 0.05)及 CEcho( P < 0.05)。(3)Bland-Altman 分析显示,CEcho 与 CMR 测量下壁厚度的一致性较好。和 Echo 与 CMR 测量下壁厚度的结果相比,CEcho 与 CMR 测量下壁厚度差值的 95% 一致性界限(CI)较小。回归分析显示 CEcho 与 CMR 测量下壁厚度的拟合度较好。(4)Holter 结果显示下壁肥厚患者出现室性早搏 ≥ 500 次/24 h 的概率大于下壁非肥厚患者。结果表明 CEcho 可以较敏感地检出左室下壁肥厚,而 Echo 可能低估左室下壁厚度。HCM 伴下壁肥厚患者发生室性早搏事件的可能性有所增加

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