心电图联合超声心动图在扩张型心肌病和缺血型心肌病鉴别诊断中的应用价值

Application value of electrocardiogram combined with ultrasoundcardiogram in differential diagnosis of dilated cardiomyopathy and ischemic cardiomyopathy

目的研究心电图(ECG)联合超声心动图(UCG)在扩张型心肌病(DCM)和缺血型心肌病(ICM)鉴别诊断中应用价值。方法选取我院收治的60例心肌病患者,根据心肌病类型将其分为DCM组和ICM组,各30例。两组均应用ECG联合UCG检查,比较两组的心功能指标、ECG检测值、心脏形态结构变化及心脏瓣膜反流情况。结果DCM组的AORT、SV、LVEF均小于ICM组,LAD、LVESD、RVID、LVDD、EPSS、E/A、RV6、RV6/RMAX均大于ICM组(P<0.05)。DCM组的左心室心尖圆薄、左心室呈拱门状、室壁节段性运动障碍、室壁矛盾运动发生率低于ICM组,左心室呈球状、弥漫性室壁运动障碍发生率高于ICM组(P<0.05)。DCM组的二尖瓣反流率高于主动脉瓣、三尖瓣、肺动脉瓣反流率(P<0.05);DCM组的主动脉瓣、三尖瓣、肺动脉瓣反流率高于ICM组(P<0.05)。结论ECG联合UCG可有效鉴别DCM和ICM,此联合检查方法安全性高,值得临床推广使用。

Objective To study the application value of electrocardiogram(ECG)combined with ultrasoundcardiogram(UCG)in the differential diagnosis of dilated cardiomyopathy(DCM)and ischemic cardiomyopathy(ICM).Methods A total of 60 patients with cardiomyopathy in our hospital were selected and divided into DCM group and ICM group according to the type of cardiomyopathy,with 30 cases in each group.Both groups were examined by ECG combined with UCG.The cardiac function indexes and ECG detection values,changes of cardiac morphology and structure and regurgitation of heart valve were compared between the two groups.Results The AORT,SV and LVEF of the DCM group were all smaller than those of the ICM group,and the LAD,LVESD,RVID,LVDD,EPSS,E/A,RV6 and RV6/RMAX were all greater than those of the ICM group(P<0.05).The incidences of left ventricular apex was round and thin,the left ventricle was arched,segmental wall dyskinesia,diffuse ventricular wall dyskinesia,ventricular wall contradictory motion of the DCM group were lower than those of the ICM group,and the incidences of the left ventricle and diffuse ventricular wall dyskinesia were higher than those of the ICM group(P<0.05).The mitral valve regurgitation rate of the DCM group was higher than the regurgitation rate of the aortic valve,tricuspid valve and pulmonary valve(P<0.05);the regurgitation rates of the aortic valve,tricuspid valve and pulmonary valve of the DCM group were higher than those of the ICM group(P<0.05).Conclusion ECG combined with UCG can effectively identify the DCM and ICM,and this joint inspection method has high safety and is worthy of clinical promotion and application.