Objective To assess the value of echocardiography combined with electrocardiogrpahy ( ECG) in diagnosis of cardiac amyloidosis. Methods The echocardiography and ECG examination in the 20 patients with cardiac amylodosis,which were diagnosed by pathological examination, were retrospectively analyzed, especially for the diagnosis rate of echocardiography itself and echocardiography combined with ECG. Results The twenty cases of cardiac amyloidosis by echocardiography examination showed 16 cases with left ventricular septal and posterior wall symmetry thickening. Fifteen cases had strong echo light-spots in myocardium, 18 cases with large left atrium and 14 cases with large right atrium. Of all, 17 cases had various degrees of left ventricular diastolic dysfunction. Fourteen cases had left ventricular systolic dysfunction and 12 cases had pericardial effusion. ECG showed 15 cases with low voltage in limb leads, 5 cases with abnormal Q waves in chest leads, 8 cases with arrhythmia and 2 cases with abnormal ST-T. The diagnosis of accordance rate by echocardiography itself was 65％( 13/20 ). But the rate of echocardiography combined with ECG was 90％ ( 18/20 ). Conclusions The echocardiography combined with ECG was helpful for improving the diagnosis rate of cardiac amyloidosis and differential diagnosis between cardiac amyloidosis and hypertensive or hypertrophic cardiomyopathy.%目的 探讨超声心动图联合心电图检查对原发性心肌淀粉样变的应用价值.方法 回顾性分析20例经病理证实的原发性心肌淀粉样变的超声心动图及心电图主要改变,对两种技术联合应用的诊断价值与应用单一技术进行比较分析.结果 20例心肌淀粉样变,超声心动图主要表现为:16例存在室间隔与左心室后壁对称性增厚;15例存在心肌内散在颗粒状强回声;18例存在左心房增大,14例存在右心房增大;17例存在不同程度舒张功能减退;14例存在射血分数减低;12例存在心包积液;心电图表现为:15例存在心电图低电压,5例存在胸导联异常Q波,8例存在心律失常,2例存在ST段改变.单独超声心动图诊断符合率为65%(13/20).超声心动图联合心电图诊断符合率为90%(18/20).结论 超声心动图联合心电图有助于提高心肌淀粉样变的诊断率,有助于心肌淀粉样变与高血压心肌肥厚和肥厚性心肌病的鉴别诊断.
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