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目的探讨心尖肥厚型心肌病(AHCM)患者的心电图(ECG)特征性改变,提高对心尖肥厚型心肌病的识别,减少误、漏诊。方法总结深圳沙井医院2004年1月-2011年2月确诊为心尖肥厚型心肌病的35例患者12导联心电图、超声心动图(UCG)特点。结果全部患者均合并有ECG异常改变(100%);胸前导联(V3~V6)T波倒置(0.1~2.8 mV),且以V3、V4、V5导联T波倒置最为明显;上述导联ST段压低(0.05~0.40 mV);V3~V5导联R波振幅明显增高;所有左心尖肥厚型病例均无异常Q波。超声心动图示心尖部肥厚达15 mm或以上伴心尖部心腔狭小者35例(100%)。结论标准12导联ECG显示胸导联V3~V5R波振幅增高伴对称性倒置T波,要高度考虑心尖肥厚型心肌病的可能,心电图异常对本病有筛选价值,而超声心动图对本病则具有确诊价值。
Objective To investigate the characteristic changes of electrocardiogram (ECG) in patients with apical hypertrophic cardiomyopathy (AHCM), and to improve the recognition of apical hypertrophic cardiomyopathy and reduce the errors and missed diagnosis. Methods The characteristics of 12-lead electrocardiogram and echocardiography (UCG) in 35 patients diagnosed as apical hypertrophic cardiomyopathy from January 2004 to February 2011 in Shenzhen Manhole Hospital were summarized. Results All patients were associated with abnormal ECG changes (100%); T wave inversion (V3 ~ V6) in the anterior chest (0.1 ~ 2.8 mV) and most obvious T wave inversion with V3, V4 and V5 leads; ST-segment depression (0.05 ~ 0.40 mV); V3 ~ V5 lead R wave amplitude was significantly higher; all patients with left apex hypertrophy were abnormal Q waves. Echocardiography showed apical hypertrophy of 15 mm or more with apex of the heart chamber narrow in 35 cases (100%). Conclusion The standard 12-lead ECG shows that the amplitude of V3 ~ V5R wave in chest lead is increased with symmetrical inverted T-wave. The possibility of apical hypertrophic cardiomyopathy should be highly considered. The abnormal electrocardiogram has screening value for this disease. It has a confirmed value.