超声心动图对心肌淀粉样变的诊断价值

The diagnostic value of echocardiography in cardiac amloidosis

目的探讨心肌淀粉样变的超声心动图特征。方法回顾分析本院1994-2007年确诊的15例原发性淀粉样变心脏受累患者的超声心动图检查结果。结果15例心肌淀粉样变患者均有不同程度的室间隔增厚（〉1．3cm），11例患者左室后壁增厚（〉1．1cm），8例房间隔增厚（〉0.6cm）。室间隔及左室游离壁心肌回声明显增强，分布不均匀，呈“毛玻璃样”改变，并可见散在颗粒样斑点状强回声。双房增大，左室射血分数减低，舒张功能受损，伴有少量心包积液。结论超声心动图能对心肌淀粉样变进行初步定性诊断和鉴别诊断。

Objective To analyze transthoracic echocardiographic characteristics of cardiac amloidosis （CA）. Methods Fifteen cases of biopsy proven CA were retrospectively reviewed. Results Interventricular septal thickening （〉1.3 cm） of varing degrees were found in all cases. In 11 cases,the posterior of left ventricular wail were thickened. Myocardial echoes of interventricular septum and free wall of left ventricular were enhanced evidently and distributed unevenly. The echoes presented as ground glass-like images, with some spotty hyper echoes. Both atria were enlarged, and LVEF decreased, with diastolic function impaired, and mild-moderate hydropericardium found in the CA. Conclusions Transthoracic eehocardiography is a relatively sensitive and highly specific non-invasive mothod to diagnose CA.