摘要
目的研究缺血性心肌病与扩张型心肌病超声心动图特征,分析超声心动图对其鉴别诊断价值,为疾病早期确诊提供依据。方法回顾性分析西安630医院于2013年8月至2020年11月收治的因心功能不全且超声提示心脏扩大而进行冠状动脉造影检查的110例患者的临床资料,按照诊断结果分为缺血性心肌病组(60例)与扩张型心肌病组(50例)。所有患者均进行超声心动图检查,比较两组患者心脏超声测量指标、心肌病瓣膜反流情况。结果缺血性心肌病组左室心尖圆而薄、左室圆拱门型、室壁节段性减弱的患者占比均显著高于扩张型心肌病组;左室球形、室壁弥漫性减弱的患者占比均显著低于扩张型心肌病组;缺血性心肌病组患者左房内径(LA)、左室舒张末期内径(LVEDD)、左室舒张末期容积(EDV)、左室收缩末期容积(ESV)、右室舒张末期内径(RVEDD)水平均显著低于扩张型心肌病组,左室射血分数(LVEF)、二尖瓣舒张晚期血流速度峰值(PVA)、主动脉瓣口收缩期峰值速度(AV)、肺动脉瓣口收缩期峰值速度(PV)水平均显著高于扩张型心肌病组(均P<0.05);缺血性心肌病组患者主动脉瓣反流(AR)总发生率高于扩张型心肌病组,但经对比,差异无统计学意义(P>0.05);缺血性心肌病组患者二尖瓣反流(MR)、三尖瓣反流(TR)总发生率均显著低于扩张型心肌病组(均P<0.05)。结论缺血性心肌病患者与扩张型心肌病患者心脏超声图像上心脏结构存在有明显不同,扩张型心肌病患者心脏腔室内径较缺血性心肌病患者更大,且TR发生率更高,临床可根据以上特征进行疾病的鉴别,以降低临床误诊概率。
Objective To study the echocardiographic features of ischemic cardiomyopathy and dilated cardiomyopathy,to analyze the differential diagnosis value of echocardiography and provide the basis for early diagnosis of the disease.Methods The clinical data of 110 patients admitted to Xi'an 630 Hospital from August 2013 to November 2020 who underwent coronary angiography due to cardiac insufficiency and cardiac dilatation indicated by ultrasound were retrospectively analyzed,according to the diagnosis results,they were divided into the ischemic cardiomyopathy group(60 cases)and the dilated cardiomyopathy group(50 cases).All patients underwent echocardiography,and the cardiac ultrasound measurement indexes and cardiomyopathy valve regurgitation of the two groups were compared.Results The proportion of patients with round and thin left ventricular apex,left ventricular round arch,and segmental weakening of the ventricular wall in the ischemic cardiomyopathy group were significantly higher than those in the dilated cardiomyopathy group;the proportion of patients with spherical left ventricle and diffuse weakening of the ventricular wall were significantly lower than those in the dilated cardiomyopathy group;the left atrial diameter(LA),left ventricular end-diastolic diameter(LVEDD),left ventricular end-diastolic volume(EDV),and left ventricular end-systolic volume(ESV),right ventricular end-diastolic diameter(RVEDD)levels of the ischemic cardiomyopathy group were significantly lower than those in the dilated cardiomyopathy group,left ventricular ejection fraction(LVEF),peak mitral valve velocity in late diastole(PVA),aortic valve peak systolic velocity(AV)and pulmonary valve peak systolic velocity(PV)were significantly higher than those in the dilated cardiomyopathy group(all P<0.05);the total incidence of aortic regurgitation(AR)in the ischemic cardiomyopathy group was higher than that in the dilated cardiomyopathy group,but the difference was not statistically significant(P>0.05);the total incidences of mitral regurgitat
作者
罗敏
LUO Min(Department of Ultrasound,Xi'an 630 Hospital,Xi'an,Shaanxi 710089,China)
出处
《大医生》
2021年第24期1-4,共4页
Doctor
关键词
缺血性心肌病
扩张型心肌病
超声心动图
主动脉瓣
肺动脉瓣
Ischemic cardiomyopathy
Dilated cardiomyopathy
Echocardiography
Aortic valve
Pulmonary valve
