淀粉样变心肌病的临床分析
发布时间：2018-12-14 14:09
【摘要】：目的：通过对淀粉样交心肌病的临床特点、治疗结果的分析,总结其一般规律。方法：本回顾性分析入选了浙江大学医学院附属第一医院心血管内科2010---2015年间收治的淀粉样变心肌病患者10例(平均年龄为59.7岁)的临床表现、实验室检查、超声心动图、心电图、特殊检查和预后。结果：在该10例患者中,男性8例,女性2例,原发性淀粉样变心肌病3例,多发性骨髓瘤相关的淀粉样变心肌病6例,1例高度怀疑为心肌淀粉样变性。10例患者均表现为进行性加重的心力衰竭,其中9例患者心功能III—IV级；1例患者心功能II级。心电图4例患者表现为肢体导联低电压,4例患者存在异常Q波,2例患者表现为束支阻滞,5例患者有不同程度的ST-T改变。超声心动图9例患者表现为左室壁肥厚且左室收缩、舒张功能减低,6例心包积液。血清学检查8例患者有肌钙蛋白I升高,8例NT-PROBNP增高。全部10例患者,有9例已死亡,1例因发病时间短,目前正在随访。结论：淀粉样变心肌病患者临床表现多表现为进行性心力衰竭,预后差,心电图多有肢体导联低电压及异常Q波表现,心超多有左室壁弥漫性对称性增厚表现,须提高认识,注意与其他心肌病鉴别诊断。
[Abstract]:Objective: to summarize the clinical characteristics and treatment results of amyloid cardiomyopathy. Methods: ten patients with amyloid cardiomyopathy (mean age 59.7 years) admitted from 2010 to 2015 in the Department of Cardiovascular Medicine, the first affiliated Hospital, School of Medicine, Zhejiang University, were retrospectively analyzed. Echocardiography, electrocardiogram, special examination and prognosis. Results: among the 10 patients, 8 were male, 2 were female, 3 were primary amyloid cardiomyopathy, 6 were amyloidosis associated with multiple myeloma. One case was highly suspected of myocardial amyloidosis. 10 cases showed progressive exacerbation of heart failure, 9 of them had III-IV grade of cardiac function. One patient had II grade of cardiac function. Electrocardiogram showed low voltage in limb lead, abnormal Q wave in 4 cases, bundle branch block in 2 cases and ST-T changes in 5 cases. Echocardiography showed left ventricular wall hypertrophy, left ventricular contraction and decreased diastolic function in 9 cases, and pericardial effusion in 6 cases. Serum levels of troponin I and NT-PROBNP were increased in 8 patients and 8 patients respectively. Of the 10 patients, 9 had died and 1 had been followed up because of short onset time. Conclusion: the clinical manifestations of patients with amyloidosis cardiomyopathy are progressive heart failure, poor prognosis, low voltage of limb lead and abnormal Q wave in electrocardiogram. Pay attention to differential diagnosis with other cardiomyopathy.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R542.2
[Abstract]:Objective: to summarize the clinical characteristics and treatment results of amyloid cardiomyopathy. Methods: ten patients with amyloid cardiomyopathy (mean age 59.7 years) admitted from 2010 to 2015 in the Department of Cardiovascular Medicine, the first affiliated Hospital, School of Medicine, Zhejiang University, were retrospectively analyzed. Echocardiography, electrocardiogram, special examination and prognosis. Results: among the 10 patients, 8 were male, 2 were female, 3 were primary amyloid cardiomyopathy, 6 were amyloidosis associated with multiple myeloma. One case was highly suspected of myocardial amyloidosis. 10 cases showed progressive exacerbation of heart failure, 9 of them had III-IV grade of cardiac function. One patient had II grade of cardiac function. Electrocardiogram showed low voltage in limb lead, abnormal Q wave in 4 cases, bundle branch block in 2 cases and ST-T changes in 5 cases. Echocardiography showed left ventricular wall hypertrophy, left ventricular contraction and decreased diastolic function in 9 cases, and pericardial effusion in 6 cases. Serum levels of troponin I and NT-PROBNP were increased in 8 patients and 8 patients respectively. Of the 10 patients, 9 had died and 1 had been followed up because of short onset time. Conclusion: the clinical manifestations of patients with amyloidosis cardiomyopathy are progressive heart failure, poor prognosis, low voltage of limb lead and abnormal Q wave in electrocardiogram. Pay attention to differential diagnosis with other cardiomyopathy.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R542.2
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