扩张型心肌病与缺血性心肌病二维彩色多普勒的对比研究

Comparison Between Dilated Cardiomyopathy and Ischemic Cardiomyopathy in Two-dimensional Echocardiography

利用二维彩色多普勒在心脏形态学、血液动力学及心室功能方面对扩张型心肌病 (DCM )及缺血性心肌病 (ICM )进行诊断及鉴别诊断。利用二维彩色多普勒技术分别测定 5 2例DCM组、ICM组及正常对照组的数据 ,利用定量和半定量的方法对数据进行测定 ,用统计学对数据进行处理。结果表明正常组分别与DCM组及ICM组比较有显著的差异 (P <0 0 5或0 0 1) ,ICM组与DCM组有比较显著的差异 (P <0 0 1)。DCM组主要是心肌弥漫性改变 ,心腔普遍扩大 ,心脏收缩功能明显减退 ,舒张功能为“正常”。多瓣膜返流发生率高且严重。ICM组以心肌局部病变为主 ,主要是左心腔扩大 ,左室收缩功能正常或轻度减低 ,舒张功能明显减低。瓣膜多为单瓣膜返流且较轻。结论 :二维彩色多普勒是临床鉴别诊断DCM和ICM最可靠、最简单及无创伤的首选方法。

This study was conducted to investigate differential diagnosis of dilated cardiomyopathy(DCM)and ischemic cardiomyopathy(ICD)according to the difference of cardiac morphology,blood flow kinetic and ventricular function made by two-dimensional color doppler flow imagine.52 cases of DCM,ICMand normal control were determined respectively by two-dimensional echocardiography and the result was analysed by using quantity and semi-quantity method. There was a predominate difference in control. ICM and DCM group(P<0.05 or 0.01),so was ICM and DCM group(P<0.01).Patients in DCM group were characterized by diffusible changes in myocardium,enlargement of ventricular cavity. Systolic function decreased greatly,but diastolic function remained normal. The mortality of multi-valves reflux was high and severe. In ICM group,changes were mainly restricted in regional myocardium. Systolic function of left ventricle was normal or a bit lower. Diastolic function decreased greatly. Single-valve was often affected and refulx took place occasionally.