心脏淀粉样变性临床及超声特点分析

Clinical and echocardiographic characteristics of cardiac amyloidosis

目的探讨心脏淀粉样变性的临床及超声特点。方法对10例心脏淀粉样变性患者进行超声心动图和心电图检查,结合病理检查分析心脏淀粉样变性的临床及超声特点。结果心脏淀粉样变性患者常见临床表现为体重减轻(9例)、乏力(8例)、浮肿(8例)、呼吸困难(7例)、胸痛胸闷(5例)、慢性腹泻(6例);心脏超声心动图表现为患者左、右心房增大,心室肥厚而心腔正常,心内膜下心肌可见强烈的超声反射光点;心电图表现为肢体导联低电压。心外活检表现为刚果红染色阳性,大部分患者合并肾脏、皮肤及消化系统损害。结论不明原因心力衰竭的患者,如伴有心肌肥厚但心电图表现为肢体导联低电压时应考虑心脏淀粉样变性的可能性。

Objective To analvze the clinical and echocardiographic characteristics of patients with cardiac amyloidosis. Methods Using echocardiogram, ECG, and pathological findings, the clinical data of 10 patients with cardiac amyloidosis were retrospectively analysed. Results Patients with cardiac amyloidosis commonly had symptoms of weight loss （9 cases） , fatigue （8 cases） , oedema （8 cases） , dyspnoea （7 cases） , chest pain （5 cases） , and chronic diarrhea （6 eases）. And they also exhibited the characteristics of large atriums, hypertrophic ventricular walls and strong echo light-spots under the endocanliomem-brahe on echocardiography, as welt as low limb lead voltage on ECG. Most patients bad renal, dermatic and gastrointestinal involvements. Conclusion Patients having cardiac dysfunction of unknown origin and meanwhile showing the characteristics of restrictive eardiomyopathy on echoc.ardiogram and low limb lead vohage on ECG should be considered the possibility of cardiac amyloidosis and need to prove it through biopsy.