超声心动图在成人暴发性心肌炎诊疗中的应用价值

Application Value of Echocardiography in Diagnosis and Treatment of Adult Fulminant Myocarditis

目的分析成人暴发性心肌炎(fulminant myocarditis,FM)的超声心动图特点,探讨超声心动图在FM诊疗中的应用价值。方法回顾性收集2018年4月~2021年3月于阜外华中心血管病医院就诊的36例成人FM患者的临床及超声心动图资料,按照出院时左心室射血分数(left ventricular ejection fraction,LVEF)是否≥50%将患者分为恢复组(n=24)和未恢复组(n=12),对两组的临床及超声心动图资料进行统计学分析,比较两组间资料差异。结果FM患者的超声表现多样,36例患者中入院时所有患者左心室室壁运动和LVEF均减低,其中瓣膜反流者35例,左心室室壁增厚者2例,左心室增大者12例,心包积液者13例,合并心腔内血栓者2例;恢复组的入院LVEF、左心室短轴缩短率及住院期间最低LVEF明显高于未恢复组(32.46%±8.65%vs 23.58%±8.21%,15.58%±4.61%vs 11.08%±4.10%,29.46%±8.82%vs 18.92%±7.05%),差异均有统计学意义(P均<0.05)。结论超声心动图在成人FM诊疗中具有重要临床价值。

Objective To analyze the echocardiographic characteristics of adult fulminant myocarditis(FM),and to explore the application value of echocardiography in the diagnosis and treatment of FM.Methods The clinical and echocardiographic data of 36 adult patients with FM who were treated at Fuwai Central China Cardiovascular Hospital from April 2018 to March 2021 were retrospectively collected.According to whether the left ventricular ejection fraction(LVEF)≥50%at discharge,the patients were divided into recovery group(n=24)and non-recovery group(n=12).The clinical and echocardiographic data of the two groups were statistically analyzed,and the data differences between the two groups were compared.Results The ultrasound manifestations of FM patients are diverse.All 36 patients had reduced left ventricular wall motion and LVEF upon admission.35 patients had valvular regurgitation,2 patients had thickened left ventricular wall,12 patients had enlarged left ventricular,13 patients had pericardial effusion and 2 patients had intracardial thrombosis.Admission LVEF,left ventricular fractional shortening,and lowest LVEF during hospitalization were significantly higher in the recovery group than in the non-recovery group(32.46%±8.65%vs 23.58%±8.21%,15.58%±4.61%vs 11.08%±4.10%,29.46%±8.82%vs 18.92%±7.05%),and the differences were statistically significant(all P<0.05).Conclusion Echocardiography has important clinical value in the diagnosis and treatment of adult FM.