扁平胸综合征心脏扁平化判断方法的评估

METHODS TO EVALUATE THE PANCAKING OF THE HEATR IN FLAT CHEST SYNDROME

经临床、X线及超声确诊的扁平胸综合征57例,分别用心胸比率、心脏横径及心脏正面面积与身高、体重的关系进行了评估。57例扁平胸综合征中有7例(12.3％)心胸比率增大(>0.50);20例(35.1％)心脏横径实测值较预计值增大10％以上;39例(68.4％)心脏正面面积求得值(即实测值)较预计值增大10％以上。因此说明扁平胸综合征确实存在心脏因受压而发生扁平化“增大”现象。但此种改变用心胸比率来衡量则阳性率很低,不能反映实际情况,建议采用心脏横径、尤其是心脏正面面积同身高、体重的关系来判断。确实有一小部分(31.6％)扁平胸综合征的心脏正面面积亦在正常范围内,提示本症除直接压迫心脏外,还可能限制或阻碍心脏的发育。

Fifty-seven cascs of flat chcst syndrome verified by clinical, X-ray and echocardiography were reported. Pancaking of the heart in these 57 cascs had been cvaluatcd with cardio-thoracic ratio, cardiac transverse diameter and frontal cardiac area in relation to height and weight. The results showed that cardio-thoracic ratio was greater than 0.5 in 7 cascs (12.3%), cardiac transverse diameter actually measurcd on the film was 10% greater than the predieted one in 20 cascs (35.1%) and that cardiac area calculated from longitudinal and broad diameter was 10% greater than predicted one in 39 cases (68.4％). It was quite convincing that cardiac pancaking resulted from being pressed in flat chest syndrome do exist. But the positivc rate is too small to express the reality by judging cardiac size with cardio-thoracic ratio. Therefore it was suggested that cardiac transverse diameter and especially fiontal cardiac area in relation to height and weight should be used to determine wheher there was cardiac pancaking or not. In addition, in a minority of cases reported, the frontal cardiac area did not increased, which suggested that flat chest syndrome might interfere the development of heart besides cardiac pancaking.