儿童心脏轻度杂音与瓣膜反流的临床观察

Children′s cardiac light murmur and valvular regurgitation clinical observation

[摘要]目的探讨儿童心脏轻度杂音与心脏瓣膜反流的相关性。方法选取2013年5月至2015年1月在该院非心脏疾病诊疗或常规体检时，听诊有心脏杂音的儿童274例，行心脏彩超、心肌酶等检查明确心脏杂音产生的原因。结果274例心脏杂音患儿中确诊为生理性杂音168例，占61．31％（168／274），先天性心脏病36例，占13．14％，继发性心脏病70例，占25．55％。生理性杂音原因中包括瓣膜反流、左室假腱索等情况，其中，瓣膜反流101例，占生理性杂音的60．12％（101／168），占整个心脏杂音的36．86％（101／274）；3～6岁心脏杂音组中瓣膜反流例数为35例，占76．09％，明显高于其他组（P〈0．05）；2～〈3岁心脏杂音纽中瓣膜反流率为38．55％，高于小于1岁纽的20．59％，差异有统计学意义（P〈0．05）；其中，心脏杂音分级为Ⅰ级的患儿中，为瓣膜反流的占53．13％，Ⅱ级为29．89％，Ⅲ级为11．86％，差异有统计学意义（P〈0．05）。结论儿童心脏听诊杂音与瓣膜反流之间存在一定的关系，通过心脏杂音可初步判断儿童器质性心脏病发生情况。

Objective To investigate correlation of children＇s cardiac light murmur and valvular regurgitation. Methods From May 2013 to January 2015 in our hospital non cardiac disease treatment or routine examination,274 cases children with heart auscultation murmur,underwent echocardiography, myocardial enzyme test to confirm the production reason of cardiac murmurs. Results A total of 274 cases children with heart murmur for physiologic murmur in 168 cases,accounted for 61.31% （168/274）, congenital heart disease 36 cases, accounted for 13. 14%, secondary heart disease 70 cases,accounted for 25. 55%. physiological murmur reason includes valve regurgitation,left ventricular false tendons and other,valvular regurgitation 101 cases, accounted for physiologic murmur 60.12% （101/168）, accounted for the entire heart murmur 36.86% （101/274） ; 3 - 6 years old heart murmur group valvular regurgitation 35 cases,accounted for 76.09%, significantly higher than other groups （P〈 0.05） ; 2 - 〈 3 years old heart murmur group valve regurgitation rate was 38.55 %, higher than that of 〈1 age groups 20.59%, the difference was statisti- cally significant （P〈0.05） ;the heart murmur classification for Ⅰ level group,valvular regurgitation accounted for 53.13% ,grade Ⅱ group was 29. 89%, Ⅲ group was 11. 86 %, there was statistically significant between three groups （P〈0.05）. Conclusion There is a certain relationship between the children cardiac auscultation murmur and valvular regurgitation, through heart murmur preliminary judgment children organic heart disease incidence.