二维超声心动图和核素心室造影对缺血性心肌病的诊断价值

A Study of the Diagnostic Value of Two-dimensional Echocardiography and Radionuclide Ventriculography in Patients With Ischemic Cardiomyopathy

目的:研究二维超声心动图和核素心室造影对缺血性心肌病(ICM)的诊断价值。方法:通过二维超声心动图和核素心室造影检测84例ICM患者的心脏形态、功能学参数以及心室壁回声特征和运动状况,并与54例扩张型心肌病(DCM)进行对比。结果:ICM左心室容量明显小于DCM(P<0.01),而心室壁较DCM为厚;ICM左心室射血分数和短轴缩短率显著高于DCM,右心室射血分数接近正常,而高峰充盈率明显低于DCM(P<0.05)。结论:ICM左心室功能不全为主,其中收缩功能相对为好,舒张功能不全较为突出,左心室壁呈不均匀薄化伴节段性运动障碍,与DCM全心功能不全,收缩、舒张功能均严重受损,心室壁普遍变薄伴弥漫性运动减弱形成鲜明对比。

Objective: To study the diagnostic value of two dimensional echocardiography and radionuclide ventriculography in patients with ischemic cardiomyopathy (ICM). Methods: Parameters of the heart shape and function, the echo characteristics and movement state of the left ventricular (LV) wall were checked up by two dimensional echocardiography and radionuclide ventriculography in 84 patients with ICM, and compared with 54 patients with dilated cardiomyopathy (DCM). Results: The LV volume of the ICM group was obviously smaller than that of the DCM group (p<0.01), but the LV wall was thicker than that of the DCM group,the LVEF and the short axle contraction rate of the ICM group were higher than those of the DCM group (all p<0.05),while the RVEF was nearly normal. But the peak filling rate was lower than that of the DCM group (p<0.05). Conclusion: In the ICM group:LV dysfunction is predominant, in which the systolic function is relatively normal while the diastolic function is markedly abnormal. The LV wall shows irregular thinning with sectionally weakened movement ;but in the DCM group :dysfunction involves both the left and right ventricles with impaired systolic and diastolic functions. The LV wall shows widespread thinning and weakened movement.