超声心动图对扩张型心肌病与缺血性心肌病的鉴别诊断

Differential Diagnosis of DCM and ICM with Echocardiography

目的 探讨超声心动图对扩张型心肌病与缺血性心肌病的鉴别诊断的临床意义。方法 本文采用二维超声心动图对 35名扩张型心肌病 (DCM) ,35名缺血性心肌病 (ICM )以及 35名正常人从心脏形态学、血流动力学和心功能三个方面进行鉴别研究。结果 ①DCM组心脏多个房室腔扩大成球形 ,室壁变薄及动度弥漫性减弱 ;ICM组以左房室腔扩大为主 ,多呈葫芦状 ,室壁活动呈节段性障碍。②反映左室充盈流量状态的EPSS ,DCM组显著高于ICM组 ;DCM组多瓣膜返流发生率较高且程度较重 ,ICM组多为单瓣膜返流且程度较轻。③DCM组以收缩功能降低为主 ,舒张功能可表现为“正常” ;ICM组则主要以舒张功能障碍为主 ,收缩功能可表现为正常。

Objective To investigate the clinical significance of the differential diagnosis of DCM and ICM with Echocardiography. Methods Echocardiography was used to analyse the cardiac morphology,hemodynamics and function in 35 cases of dilated cardiomyopathy (DCM),35 cases of Ischemic cardiomyopathy(ICM) and 35 normal persons. Results ① In morphology, several atrioventricular cavities of DCM mostly enlarged,the ventricular wall motion decreased widely.The ICM heart is limitedly enlarged, the ventricular wall motion decreased segmentally.② In hemodynamics,the EPSS reflecting left ventricular filling and the flowing status in DCM are much higher than that in ICM; the incident rate of valvular regurgitation in DCM is much higher than that in ICM; the degree valvular regurgitation in DCM is more severe than that in ICM.③ In cardiac function, DCM is marked by lower ventricular systolic function and“normal' ventricular diastolic function. While ICM is mainly characterized by ventricular diastolic function,which may occur with normal ventricular systolic function while ICM is mainly characterized by ventricular diastolic disfunction, which may occur with normal ventricular systolic function. Conclusions Echocardiography can offer the relatively reliable index for the clinical differential diagnosis of DCM and ICM.