超声心动图鉴别诊断扩张型心肌病与缺血型心肌病价值研究

Value of Echocardiography in Differential Diagnosis of Dilated Cardiomyopathy and Ischemic Cardiomyopathy

目的探讨超声心动图诊断扩张型心肌病(DCM)及缺血性心肌病(ICM)诊断价值。方法选择2011年5月至2016年9月收治的扩张型心肌病64例(DCM组)与缺血性心肌病64例(ICM组),并随机抽取同时期健康体检者64名作为对照组,对比超声心动图心脏形态学参数:左房内径(LAD)、左室舒张末期内径(LVDd)、左室收缩末期内径(LVDs)、右室内径(RVD)、主动脉宽度(AO);心功能参数:每搏量(SV)、射血分数(EF)和E峰至室间隔距离(EPSS)等。结果 DCM组除AO外其他参数均高于ICM组和对照组,ICM组除RVD外均高于对照组(均P<0.05)。心功能参数DCM组均高于ICM组和对照组,ICM组除SV外均高于对照组(均P<0.05)。DCM组中有较多瓣膜中~重度反流,其反流情况重于ICM组和对照组,ICM组反流明显重于对照组(均P<0.05)。结论超声心动图可发现和评估扩张型心肌病及缺血性心肌病与健康人群的特征性差异,对临床诊断有应用价值。

Objective To investigate the value of echocardiography in diagnosis of dilated cardiomyopathy（ DCM） and ischemic cardiomyopathy（ ICM）. Methods There were 64 cases of dilated cardiomyopathy（ DCM group） and 64 cases of ischemic cardiomyopathy（ ICM group） in our hospital from May 2011 to September 2016. 64 cases were randomly selected from healthy examination people as control group at the same period. Cardiac morphological and heart function parameters were detected by echocardiography. Cardiac morphological parameters included echocardiography left atrial diameter（ LAD）,left ventricular end diastolic diameter（ LVDd）,left ventricular systolic diameter（ LVDs）,right ventricular diameter（ RVD）,aorta（ AO）. And heart function parameters included stroke volume（ SV）,ejection fraction（ EF） and E peak to ventricular septal（ EPSS）. Results Except AO,the cardiac morphological parameters in DCM group were significantly higher than ICM and control group,and except RVD the data of ICM group were higher than the control group（ all P 〈0. 05）. The parameters of heart function in DCM group were higher than that of ICM and control group. Furthermore,except SV the data of ICM group were higher than the control group（ all P 〈0. 05）. In the DCM group there had more patients who has moderate to severe valve regurgitation,and their valve regurgitation was heavier than the ICM and control group,meanwhile the valve regurgitation in ICM group was significantly heavier than the control group（ P 〈0. 05）. Conclusion Echocardiography could clearly distinguish and assess the cardiac conformation and functional characteristic in ICM,DCM and healthy people and it has the value of clinical diagnosis.