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目的探讨心电图联合超声心动图检查在心尖肥厚型心肌病(AHCM)患者中的应用价值。方法选取2009年5月—2014年12月陕西省中医医院收治的AHCM患者49例作为病例组,选取同期在本院体检的健康成年人30例作为对照组。两组受试者均行常规12导联心电图检查及超声心动图检查并比较两组检查结果。结果病例组患者不同导联心电图R波振幅增高幅度和ST段下移幅度均高于对照组(P<0.05)。病例组患者心尖厚度、左心房内径(LAD)、室间隔厚度(IVS)、左心室后壁厚度(LVPW)、心尖与后壁厚度比值、舒张早期充盈峰速度(E峰)、E/A比值高于对照组,舒张晚期充盈峰速度(A峰)低于对照组(P<0.05);两组受试者左心室收缩末期内径(LVDs)、左心室舒张末期内径(LVDd)、左心室缩短分数(FS)、左心室射血分数(LVEF)比较,差异无统计学意义(P>0.05)。病例组患者S_(V1)+RV5、R_(V2)+S_(V1)、S_(V3)+R_(aVL)、ΣQRS及R_(V3)+S_(V1)高于对照组(P<0.05)。Pearson相关分析结果显示,R_(V2)+S_(V1)和R_(V3)+S_(V1)分别与LAD、LVDd呈正相关(P<0.05)。结论心电图超声联合超声心动图检查不仅可评价AHCM患者左心功能和心肌肥厚,还可直接观察心脏形态和肥厚区域,应用价值较高
Objective To investigate the value of electrocardiogram echocardiography in patients with apical hypertrophic cardiomyopathy (AHCM). Methods Forty-nine patients with AHCM who were treated in Shaanxi Provincial Hospital of Traditional Chinese Medicine from May 2009 to December 2014 were selected as the case group. Thirty healthy adults were selected as the control group during the same period. Two groups of subjects underwent routine 12-lead ECG and echocardiography and compare the two groups of test results. Results The amplitude of R wave amplitude and ST segment downward trend of electrocardiogram in different lead cases were higher in case group than in control group (P <0.05). The apical thickness, left atrium diameter (LAD), interventricular septum thickness (IVS), left ventricular posterior wall thickness (LVPW), apical and posterior wall thickness ratio, early peak diastolic filling velocity (E peak) and E / A ratio Compared with the control group, peak A velocity in late diastolic phase was lower than that in control group (P <0.05). Left ventricular end-systolic diameter (LVDs), left ventricular end diastolic dimension (LVDd) FS, LVEF, the difference was not statistically significant (P> 0.05). The patients in the case group had higher S_ (V1) + RV5, R_ (V2) + S_ (V1), S_ (V3) + R_ (aVL), ΣQRS and R_ (V3) + S_ (V1) . Pearson correlation analysis showed that R V2 + S V1 and R V3 + S V1 were positively correlated with LAD and LVDd (P <0.05). Conclusion Electrocardiogram echocardiography combined with echocardiography can not only evaluate left ventricular function and cardiac hypertrophy in patients with AHCM, but also directly observe the morphology and hypertrophy of the heart area, with high value