超声心动图在克山病患者自我治疗疗效中的评价

Evaluation on the effect of self-treatment in patients with Keshan disease by echocardiography

目的应用超声心动图评价克山病患者自我治疗的疗效，观察心脏形态及功能变化。方法观察经自我治疗的31例克山病患者治疗前、治疗后3个月及6个月时的左房内径（LAd）、左室舒张末期内径（LVEDd）、室间隔舒张末期厚度（IVSTd）、左室后壁舒张末期厚度（LVPWTd）、左室质量（LVM）、左室质量指数（LVMI）、相对室壁厚度（RWT）、左室射血分数（LVEF）、二尖瓣血流E／A值大小及变化情况。结果克山病患者经自我治疗3个月后LAd、IVSTd、LVEDd、LVPWTd、LVM、LVMI及RWT测值均较治疗前减小，治疗6个月后进一步减小，差异有统计学意义（P〈0．05）。LVEF值与治疗前相比略有增大，但差异无统计学意义（P〉0．05）。结论克山病患者经自我治疗后左室肥厚及左室重构受到限制，并发生了逆转，心功能得到了相应改善。超声心动图为克山病患者自我治疗疗效的评价提供了有效的方法，并为临床治疗提供指导。

Objective To evaluate the effect of selPtreatment and observe the change of heart morphology and function in patients with Keshan disease by echocardiography. Methods The left atrium diameter（LAd） ,left ventricular end-diastolic diameter（LVEDd）, the thickness of interventricular septum in end-diastolic（IVSTd）, the thickness of left ventricular posterior wall in end-diastolic（LVPWTd）, the left ventricular mass（LVM）, the left ventricular mass index（LVMI）, the relative wall thickness（RWT）, the left ventricular ejection fraction（LVEF） and the mitral valve flow E/A ratio（E/A） were measured before the self-treatment by echocardiography,and also measured on the 3rd month and 6th month after self-treatment with the same method,and observed the change of the parameters above. Results The LAd, LVEDd, IVSTd, LVPWTd, LVM, LVMI and RWT decreased on the 3rd month after self-treatment compared with prior self-treatment,and decreased on the 6th month further. There was significant difference between the prior self-treatment and post self-treatment （ P 〈0.05）. The mitral valve flow E/A ratio and LVEF increased on the post self-treatment compared with the prior self-treatment slightly, but there was no statistical difference （ P 〉 0.05）. Conclusions Left ventricular hypertrophy and remodeling in patients with Keshan disease were prevented and reversed,and the cardiac function were improved after the self-treatment. Echocardiography can be used to evaluate the effect of self-treatment on patients with Keshan disease and can provide direction for clinical treatment.