超声心动图与体表心电图对诊断心尖室壁瘤的研究

Echocardiography and electrocardiogrophic in detecting the apical aneurysm

目的 :探讨超声心动图和体表心电图对诊断心尖室壁瘤的价值。方法 :以 38例急、慢性心肌梗死并心尖室壁瘤患者为研究对象 ,对超声心动图和体表心电图在诊断心尖室壁瘤的敏感性进行比较。结果 :① 38例心尖室壁瘤病人在超声心动图上最多见的异常室壁节段为前壁及间隔心尖段 ,敏感性为 10 0 % ,其次为侧壁心尖段、下壁心尖段 ,敏感性分别为 4 8%、4 0 %。②心电图以病理性Q波和V1～ 5多个导联ST段抬高 (V1～ 3 0 .2mv ;V4～ 60 .1mv) ,诊断室壁瘤的敏感性为 71% ,各胸导联ST段抬高的诊断敏感性为 :V12 9% ,V2 71% ,V3 4 8% ,V44 2 % ,V52 5 % ,下壁、侧壁导联的ST段改变。结论 :超声心动图对心尖室壁瘤的诊断是首选诊断方法。而心电图以病理性Q波和ST段抬高V1～ 3 0 .2mv ,V4～ 60 .

Objective: To evaluate the value of echocardiography and electrocardiographic in detecting apical aneurysm.Methods: Apical aneurysm in 38 patients with acute and old myocardial infarction were tested by means of echocardiography (2DE) and electrocardiographic (ECG) separately.Results: ①Apical anterior wall abnormality and Apical septal wall abnormality were obtained and the sensitivity were 100%, the sensitivity of Apical lateral wall and apical inferior wall were 48%,40%, respectively. ②The total sensitivity in the diagnosis of apical aneurysm by using ECG, abnormal Q waves and ST V 1～5 segment evaluation (ST V 1～3 0.2mv;ST V 4～6 0.1mv were 71%; The sensitivity of ST V 1～5 segment evaluation were V 129%,V 271%,V 348%,V 442%,V 525%, respectively. ST segment of lateral and inferior leads were not changed. Conclusions: 2DE should be first chose to identify the patients with apical aneurysm, while ECG was also a kind of effective method.