学龄儿童扩张型心肌病彩色多普勒超声心动图特征和规律性研究

Study on the characteristics and regularity of color Doppler echocardiography in school-age children with dilated cardiomyopathy

目的探寻学龄儿童扩张性心肌病(DC)彩色多普勒超声心动图(CDE)特征和规律性。方法 39例学龄儿童DC患者,同期30例性别年龄体重相近的正常学龄儿童志愿者作为对照组,应用CDE对比观察,寻找DC患儿CDE特征和规律性,M型超声测量计量数据以(±s)表示,采用统计学t检验。结果应用CDE对39例学龄儿童DC全部做出正确诊断,学龄儿童DC的CDE特征和规律性明显:1)DC组所有患儿二维超声心动图显示左心室内径和左心房内径不同程度增大,室间隔与左心室后壁运动幅度不同程度降低;2)DC组所有患儿M型超声心动图显示二尖瓣运动曲线幅度降低,呈"钻石样"改变;3)M型超声心动图测量DC组与对照组数据左心室内径(48.2±3.3)mm/(40.9±3.6)mm、左心房内径(28.2±3.4)mm/(21.5±3.1)mm、左室舒张末期容积指数(93.3±9.8)ml/m^2/(58.3±8.9)ml/m^2和左心室射血分数(41.1%±3.7)%/(68.1±2.1)%经计学t检验,差异性显著(P<0.001);室间隔厚度(5.1±0.3)mm/(5.2±0.4)mm、左心室后壁厚度(5.0±0.3)mm/(5.1±0.4)mm,经统计学t检验,差异不明显(P>0.05);4)DC组所有患儿彩色多普勒血流显像于收缩期均显示过二尖瓣不同程度五彩镶嵌返流束血流信号。结论学龄儿童DC的CDE特征和规律性明显,CDE对学龄儿童DC具有特异性诊断价值,但需与左室心肌致密化不全相鉴别。

Objective To explore the characteristics and regularity of color Doppler echocardiography （CDE） in school-age children with dilated cardiomyopathy （DE）. Methods 39 consecutive school - age children with DC were selected as a study group and, at the same period, 30 normal children volunteers with similar sex, age, and body weight were taken as a control group. By use of CDE for the comparative observation, we tried to seek the characteristics and regularity of CDE in school-age children with DE. M type ultrasonic measurement data were presented as （ x- ± s ） and t test applied for statistics. Results By the application of CDE in 39 cases of school-age children, all school-age children with DC were correctly diagnosed. The characteristics and regularity of CDE in children with DC were as follows： 1 ） In the DC group, two-dimensional echocardiography showed that the left ventricular diameter and left atrial diameter increased to varying degrees, wall motion amplitude of interventricular septum and left ventricular posterior wall decreased; 2） In the DC group, M type echocardiography showed that the mitral valve motion curve was greatly reduced, presenting with the ＂ diamond＂ change; 3） In DC group/control group, M type ultrasound measurement showed that the left ventricular diameter was （48.2 ± 3.3 ） mm/（40.9 ± 3.6） mm, left atrial diameter was （ 28.2 ± 3.4） mm/（ 21.5 ± 3.1 ） mm, left ventricular end diastolic volume index was （ 93.3 ± 9.8 ） ml/m2/（ 58.3 ± 8.9 ） ml/ m2 and left ventricular ejection fraction was （41.1 ± 3.7 ） % / （ 68.1 ± 2.1 ） %, correspondingly. By t test, the difference was significant （ P 〈 0. 001 ）. The ventricular septal thickness was （5.1 ± 0.3 ） ram/（ 5.2±0.4） mm, left ventricular posterior wall thickness was （5 ±0.3） mrn/（5.1 ±0.4） mm. By t test, no significant difference was found （ P 〉0.05） ; 4） In DC group, color Doppler flow imaging in systole showed that, through the mitral valve regurgitation, the colorful mosaic blood flow signal exhibited in different degrees. Conclusion The DC in school-age children with Children DC possesses the obvious characteristics and regularity of CDE, which has specific diagnostic value for this disorder. Children＇ s DC, however, should be differentiated from the left ventricular non-compaction.