【摘要】：目的：通過對淀粉樣交心肌病的臨床特點、治療結(jié)果的分析,總結(jié)其一般規(guī)律。方法：本回顧性分析入選了浙江大學(xué)醫(yī)學(xué)院附屬第一醫(yī)院心血管內(nèi)科2010---2015年間收治的淀粉樣變心肌病患者10例(平均年齡為59.7歲)的臨床表現(xiàn)、實驗室檢查、超聲心動圖、心電圖、特殊檢查和預(yù)后。結(jié)果：在該10例患者中,男性8例,女性2例,原發(fā)性淀粉樣變心肌病3例,多發(fā)性骨髓瘤相關(guān)的淀粉樣變心肌病6例,1例高度懷疑為心肌淀粉樣變性。10例患者均表現(xiàn)為進行性加重的心力衰竭,其中9例患者心功能III—IV級；1例患者心功能II級。心電圖4例患者表現(xiàn)為肢體導(dǎo)聯(lián)低電壓,4例患者存在異常Q波,2例患者表現(xiàn)為束支阻滯,5例患者有不同程度的ST-T改變。超聲心動圖9例患者表現(xiàn)為左室壁肥厚且左室收縮、舒張功能減低,6例心包積液。血清學(xué)檢查8例患者有肌鈣蛋白I升高,8例NT-PROBNP增高。全部10例患者,有9例已死亡,1例因發(fā)病時間短,目前正在隨訪。結(jié)論：淀粉樣變心肌病患者臨床表現(xiàn)多表現(xiàn)為進行性心力衰竭,預(yù)后差,心電圖多有肢體導(dǎo)聯(lián)低電壓及異常Q波表現(xiàn),心超多有左室壁彌漫性對稱性增厚表現(xiàn),須提高認識,注意與其他心肌病鑒別診斷。
[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.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R542.2

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