52例扩张型心肌病的X线、超声及心电图综合研究评价

Comprehensive analysis of X-ray,echocardiography and electrocardiography in patients with dilated cardiomyopathy

目的 :为了解扩张型心肌病 (DCM)的临床、X线、B超与心电图之间的规律性联系。方法 :作者回顾性分析了 5 2例被临床证实的DCM患者。结果 :心脏X线检查 :①肺淤血占 70 % ( 3 7/5 2 ) ;② 5 9 6 %心脏扩大呈“普大”或“主动脉”型 ;③心胸比率 :0 5 3 4占 2 8 8%、0 5 7～ 0 6 5占 6 1%、0 71有 5例 ,且全部死亡 ;④心搏 :正常者有 15例 ,减弱者有 3 7例 (占 71% ) ;⑤ 2例 5 0岁以上患者行冠状动脉造影均示正常。B超 :①左室质量指数为 185 3 5± 6 4 6 2g/m2 ,比正常值增高 ;② 10例死亡的患者中 ,左室质量指数为 2 5 8 0 3g/m2 比其它患者明显增高 (P <0 0 0 5 )。心电图 :①房颤 15例 ,左束支传导阻滞 (LBBB ,6例 ) ;②室性早搏 (VP ,17例 ) ;③非持续性室早搏和持续性早搏分别占 9例和 5例 (后 5例均已死亡 )。结论 :肺淤血、心脏体积增大及心搏减弱越严重 ,左室质量指数则越高 ;持续性室性早搏发生的越频繁 ,对扩张型心肌病的诊断就越可靠 ,预后就越差。然而 ,尽管X线、B超与心电图都有一些特点 ,但各有其局限性 。

Objective:To investigate the relationship among the clinical,X ray,Ultrasonic cardiogram (UCG) and Electro cardiogram (ECG) of Dilated cardiomyopathy (DCM).Methods:52 confirmed cases with DCM were retrospectiovely studied.Results:Cardiac Radiography:①70% with lung congestion (37/52);②59 6% with “Pancardiac”or“aortic type”enlargement of cardiac shadow (31/52);③Cardiothoracic rate 0 534 (28 8% of all the cases),0 57～0 65 (61%),0 71(5 patients,all died);④Heart beats:normal in 15 patients,weakened in 37 patients (71%);⑤Coronary angiography:2 patients over 50 who subjected to coronary angiography all showed normal result. UCG:①LVMI 185 35±64 62g/m 2 were higher than normal value;②In dead 10 cases, LVMI were 258 03g/m 2 which is markedly higher than that in others ( P <0 005). ECG:①Atrial fibrillation (15 cases),Left bundle branch block (LBBB,6 cases),Ventricular presystole (VP) 17 cases,nonsustained VP and sustained VP were 9 and 5 cases respectively,and all the latter died.Conclusions:The more serious palmonary congestion,cardiac enlargement and weakend cardiac beats are,the highter LVMI is,the more frequent and sustained VP occurs,the more reliable diagnosis of MCM is,and the worse the prognosis.However,X ray,UCG and ECG all have its limitation though they have their characteristics.Therefore,to evaluate the diagnosis and to predict progrosis,a comprehensive analysis of these examinations should be necessary .