经皮肾穿刺活检诊断淀粉样变性患者超声心动图特点及其预后分析
作者:
作者单位:

(西安交通大学第一附属医院,陕西省西安市 710061)

作者简介:

王颖,硕士研究生,主治医师,研究方向为老年冠心病基础与临床研究,E-mail为wy2610@126.com。通信作者王晓虹,博士,主任医师,教授,硕士研究生导师,研究方向为老年冠心病基础与临床研究,E-mail为291406264@qq.com。

基金项目:

陕西省科技攻关项目(2016JM8082)


Echocardiographic characteristics and prognosis of patients with amyloidosis diagnosed by renal biopsy
Author:
Affiliation:

The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710061, China)

  • 摘要
  • | |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
    摘要:

    目的 通过分析经皮肾穿刺活检明确诊断为淀粉样变性肾病伴心脏受累患者的临床及超声心动图特点,为心肌淀粉样变性患者的早期诊断提供帮助。方法 共纳入经皮肾穿刺活检确诊的淀粉样变性肾病患者45例,收集患者行肾穿刺活检时的临床资料(年龄、性别、血压等)、超声心动图指标(室间隔厚度、左心室舒张期末内径、左心室射血分数等),对比心脏受累与未受累者指标差异及预后。结果 超声心动图指标分析显示,心脏受累组较未受累组室间隔厚度、左心室后壁厚度增加,差异具有统计学意义(P<0.05)。心脏受累组中位生存期15月,较心脏未受累组明显下降,差异具有统计学意义(P<0.05)。结论 经皮肾穿刺活检诊断淀粉样变性患者超声心动图提示室间隔厚度及左心室后壁厚度增加,且室间隔厚度≥10 mm,可作为判断是否合并心肌淀粉样变性的早期依据。

    Abstract:

    Aim To analyze the clinical and echocardiographic characteristics of patients with amyloidosis diagnosed by renal biopsy, in order to provide help for the early diagnosis of patients with myocardial amyloidosis. Methods This study included a total of 45 patients with amyloidosis nephropathy diagnosed by renal biopsy. Clinical data (age, gender, blood pressure, etc) and ultrasonic cardiac indicators (interventricular septal thickness, left ventricular end-diastolic diameter, left ventricular ejection fraction, etc) of patients undergoing renal biopsy were collected, and the differences of indicators and prognosis between patients with and without cardiac involvement were compared. ResultsThe interventricular septal thickness and left ventricular posterior wall thickness increased in patients with cardiac involvement compared with the patients without cardiac involvement (P<0.05). The median survival time was 15 months in patients with cardiac involvement, which was significantly lower than that of patients without cardiac involvement(P<0.05).Conclusion The echocardiography of patients with amyloidosis diagnosed by renal biopsy indicates that both interventricular septal thickness and left ventricular posterior wall thickness increase, and the interventricular septal thickness is more than 10 mm, which can be used as the early basis to determine whether the patients are complicated with myocardial amyloidosis.

    参考文献
    [1] 中国系统性淀粉样变性协作组, 国家肾脏疾病临床医学研究中心.系统性轻链型淀粉样变性诊断和治疗指南.中华医学杂志, 6,6(44):3540-3548.
    [2] 刘世诺, 姚自鹏, 宗政, 等.心肌淀粉样变性.中国老年学杂志, 8,8(4):1020-1023.
    [3] Chen Y, Shlofmitz E.Should patients with cardiac amyloidosis be prioritized for heart transplantation?.J Card Fail, 9,5(9):772-773.
    [4] Maurer MS, Grogan DR, Judge DP, et al.Tafamidis in transthyretin amyloid cardiomyopathy:effects on transthyretin stabilization and clinical outcomes.Circ Heart Fail, 5,8(3):519-526.
    [5] 苏春晓, 吴棘, 蒋春兰, 等.超声心动图对心肌淀粉样变性的诊断价值.广西医科大学学报, 7,4(7):971-973.
    [6] Nicol M, Baudet M, Brun S, et al.Diagnostic score of cardiac involvement in AL amyloidosis.Eur Heart J Cardiovasc Imaging, 9,1(5):542-548.
    [7] Marwic TH, Gillebert TC, Aurigemma G, et al.Recommendations on the use of echocardiography in adult hypertension:a report from the European Association of Cardiovascular Imaging (EACVI) and the American Society of Echocardiography (ASE).J Am Soc Echocardiogr, 5,8(7):727-754.
    [8] Lee GY, Kim K, Choi JO, et al.Cardiac amyloidosis without increased left ventricular wall thickness.Mayo Clin Proc, 4,9(6):781-789.
    [9] Finocchiaro G, Pinamonti B, Merlo M, et al.Focus on cardiac amyloidosis:a single-center experience with a long-term follow-up.J Cardiovasc Med (Hagerstown), 3,4(4):281-288.
    [10] Falk RH.Cardiac amyloidosis:a treatable disease, often overlooked.Circulation, 1,4(9):1079-1085.
    相似文献
    引证文献
引用本文

王颖,杨伟,李慧贤,苏显明,王晓虹.经皮肾穿刺活检诊断淀粉样变性患者超声心动图特点及其预后分析[J].中国动脉硬化杂志,2020,28(9):785~788.

复制
分享
文章指标
  • 点击次数:412
  • 下载次数: 631
历史
  • 收稿日期:2019-08-20
  • 最后修改日期:2019-10-26
  • 在线发布日期: 2020-10-28