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中华医学超声杂志(电子版) ›› 2026, Vol. 23 ›› Issue (04) : 330 -336. doi: 10.3877/cma.j.issn.1672-6448.2026.04.010

综述

超声心动图在轻链型心脏淀粉样变诊断与预后评估中的研究进展
祝婧轶1,2, 张鑫3, 刘丽文2, 郑敏娟2,()   
  1. 1 716000 延安大学延安医学院
    2 710032 西安,空军军医大学西京医院超声科
    3 716000 延安大学附属医院超声科
  • 收稿日期:2025-12-05 出版日期:2026-04-01
  • 通信作者: 郑敏娟

Recent advances in echocardiography for diagnosis and prognostic assessment of light-chain cardiac amyloidosis

Jingyi Zhu, Xin Zhang, Liwen Liu   

  • Received:2025-12-05 Published:2026-04-01
引用本文:

祝婧轶, 张鑫, 刘丽文, 郑敏娟. 超声心动图在轻链型心脏淀粉样变诊断与预后评估中的研究进展[J/OL]. 中华医学超声杂志(电子版), 2026, 23(04): 330-336.

Jingyi Zhu, Xin Zhang, Liwen Liu. Recent advances in echocardiography for diagnosis and prognostic assessment of light-chain cardiac amyloidosis[J/OL]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2026, 23(04): 330-336.

表1 免疫球蛋白轻链型(AL型)心脏淀粉样变(CA)超声心动图评分体系比较
图1 心脏淀粉样变患者超声心动图测量指标。图a:淀粉样变典型超声表现,左心室心肌增厚,室间隔呈“颗粒样强回声改变,双心房增大,心包腔少量积液;图b:相对室壁厚度=(室间隔厚度+ 左心室后壁厚度)/ 左心室舒张末期前后径;图c:二维斑点追踪显像纵向应变牛眼图,左心室整体纵向应变绝对值减低,其中基底段和中间段明显减低(浅红色),而心尖部相对保留(深红色),呈“心尖保留”征象,应变绝对值越大颜色越深,提示心肌收缩功能越好;图d:二尖瓣E峰流速(E),二尖瓣A峰流速(A);图e:间隔侧二尖瓣环舒张早期峰值速度(e')、二尖瓣环舒张晚期峰值速度(a')、二尖瓣环收缩期峰值速度(s)均<5 cm/s;图f:三尖瓣环收缩期位移(TAPSE) 注:RV为右心室,IVS为室间隔,LV为左心室,LVPW为左心室后壁,AO为主动脉,LA为左心房,LV为左心室,PE为心包积液
表2 心脏淀粉样变与其他表现为左心室肥厚疾病的鉴别要点
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