老年心尖球形综合征的临床特征

The Clinical Features of the Elderly with Apical Ballooning Syndrome

目的：了解我国老年心尖球形综合征（ABS）患者的临床特征。方法：对2013年9月前国内医学期刊报道的60例老年ABS患者临床资料进行汇总分析。结果：93．3％为女性患者；75％的患者有应激因素；95％的患者表现为胸痛胸闷；23％并发左心功能不全或肺水肿；20％并发心源性休克或低血压；100％的患者出现心电图异常改变，其中88．3％呈ST段抬高，42％出现T波倒置，25％出现病理性Q波，53．3％并发心律失常；93％的患者冠脉造影正常，急性期左心室造影及超声心动图检查显示，左室心尖部及中段呈气球样膨出，运动明显减弱或消失，而左室基底部运动增强，并于36h～1月后恢复正常，全部病例痊愈或好转出院；80％诊断为冠心病等疾病。结论：我国老年ABS患者的临床表现及心电图改变酷似急性心肌梗死，但冠脉造影无明显狭窄，早期行心血管造影及超声心动图检查对正确诊治具有重要意义。

OBJECTIVE ： To understand the clinical features of the elderly patients with Apical Ballooning Syndrome （ABS） in our country. METHOD ： The clinical data of the 60 cases of the elderly patients with ABS reported by the domestic medical journals was summaried and analyzed. RESULTS： 93.3% of the patients were female. 75% among of them had stress factors. 95% presen- ted chest pain and chest thghtness. 23% had the concurrence of left ventricular dysfunction or pulmonary edema. 20% were compli- cated by cardiogenic shock or hypotension. 100% of them had ECG changes which 88.3% showed that ST - segment elevated 0. 1 mv -0. 8mv which was down from 30 -one week. 42% had T wave inversion and 25% had pathologic Q waves which disappeared from 6 hours - one month. 53.3% had arrhythmia and 93% had normal coronary angiography. The examination of acute left ventricular angiography and eehocardiography showed that left ventrieular apex and the middle had balloon - like bulge whose function weakened or dis- appeared significantly, but the function of left ventricular base increased. They returned to the normal from 36 hours - one month. All patients were cured or improved and dischanged. 80% of them were diagnosed as coronary heart disease and other diseases. CONLUSIONS： The clinical manifestations and the changes of ECG of the elderly patients with ABS are exactly like acute myocardial infarction, but there is no significant stenosis of coronary angiography. The early examination of cardiovascular angiography and treatment are necessary.