围生期心肌病治疗前后的超声观察及临床分析

Cardiomyopathy in the Perinatal Before and After Treatment of Ultrasonic Observation and Clinical Analysis

目的探讨心脏彩超观察围生期心肌病治疗转归的临床价值。方法用彩色多普勒超声观察了35例围生期心肌病患者治疗前后及随访6个月后的心脏结构及功能改变,测定了左心室舒张末期经(LVEDD)、左心室收缩末期经(LVESD)、左室射血分数(LVEF)、左室短轴收缩率(FS)、二尖瓣峰值速度比率(E/A)、心室等容舒张期和等容收缩期之和与心室射血时间比值(Tei指数)、综合病程、病史、临床表现综合分析。结果围生期心肌病患者治疗前左心室扩大、Tei指数增高者检出率均为100%,明显高于治疗后及随访6个月后;治疗前LVEF、LVFS测值减低者检出率均为100%,明显低于治疗后及随访6个月后。治疗前二尖瓣、三尖瓣、主动脉瓣、肺动脉瓣膜口反流的检出率分别为100%,74.3%,57.1%,51.4%,明显高于治疗后及随访6个月后。结论心脏彩超能够观察围生期心肌病的临床转归,对围生期心肌病的诊断、鉴别诊断、预后评估及治疗后随访观察均具有重要价值。

Objective Discussion the clinical value of cardiac ultrasound to observe the treatment outcome of perinatal cardiomyopathy. Methods Color Doppler ultrasound was used to observe the changes of cardiac structure and function of 35 cases of perinatal period cardiomyopathy before and after treatment of patients after 6 months, the left ventricular end diastolic was determined（LVEDD）, left ventricular end systolic by（LVESD）, left ventricular ejection fraction（LVEF）, left ventricular short axis shrinkage（FS）, peak transmitral velocity ratio（E/A）, ventricular isovolumic diastolic and systolic isovolumic and ventricular ejection time ratio（Tei index）,analysis of comprehensive course,medical history and clinical manifestation. Results The perinatal period cardiomyopathy before treatment, left ventricular enlargement, Tei index increased the detection rate was 100%,significantly lower than that after treatment and after 6 months of follow-up;Before treatment each valvular reflux inspection rate were 100%, 74.3%, 57.1%,51.4%, significantly higher than that after treatment and followed up for 6 months after. Conclusion Cardiac color Doppler ultrasound can observe the clinical prognosis of peripartum cardiomyopathy and have important value on perinatal period cardiomyopathy diagnosis, differential diagnosis and prognosis assessment and postoperative follow-up observation.