围产期心肌病超声诊断指标与治疗、预后关系的研究

Study of the relation of ultrasonographic manifestation and diagnosis and prognosis on paripartum cardiomyopathy.

目的 :研究围产期心肌病患者的超声检查与疗效及预后的关系 ,探讨超声心动图在围产期心肌病的早期诊断和预后评估中的价值。方法 :选择围产期心肌病 (PCM)2 5例 ,原发性扩张型心肌病 (DCM) 2 3例和正常对照 2 0例 ,分别于治疗前及治疗 10d、2 0d行心脏超声检查 ,测量左心室 (LV)、左心房 (LA)、右心室 (RV)、右心房 (RA)及主动脉(AO)内径 ,室间隔和左室后壁厚度 ,肺动脉平均压及左室射血分数 (EF) ,并加以比较。结果 :(1)治疗前PCM及DCM两组左室内径分别为 63.8± 5 .2mm和 72 .1± 6.9mm ,差异有显著性 (均P <0 .0 1) ,两组EF值及肺动脉压比较差异亦有显著性 ;(2 )治疗 10d及 2 0d时 ,PCM组LVD较治疗前显著缩小 ,肺动脉压显著降低 ,EF值显著增大 ,(10d时P <0 .0 5 ,2 0d时P <0 .0 1)。且治疗 2 0d时肺动脉压较治疗前显著降低 ;(3)治疗 2 0d时 ,PCM组在LVD、肺动脉平均压及EF值方面的改善较DCM组差异有显著性差异。结论 :PCM超声心动图改变与DCM相似 ,但程度不同 ;借助超声心动图检查可以早期诊断PCM ;

Objective:To study the relation between ultrasonographic manifestation and the effect as well as the prognosis of the peripartum cardiomyopathy (PCM) patients;To investigate the value of the ultrasonographic examination in the early diagnosis and investigate the prognosis valuation for PCM.Methods:Echocardiographic examination of 25 PCM and 20 normal control (NC) female and 23 DCM female were completed with model at the follow 3 time:before the therapy,10 days therapy later,20 days therapy later.Results:(1)Before the therapy,the left ventricular dimension (LVD) of PCM and DCM were 63.8±5.2mm and 72.1±6.9mm respectively.There was statistical difference (P<0.01) when they were compared.(2)Whatever after 10 or 20 days therapy,in PCM patients the LVD and the pulmonary artery pressure decreased and the EF increased significantly than therapy before (10 days P<0.05,20 days P<0.01).(3)20 days therapy later,the LVD,pulmonary artery pressure and the EF in PCM were improved significantly than that in DCM.Conclusion:The ultrasonograpic manifestation in PCM and DCM are similar,but the changing degree are difference.The ultrasonographic exam can do good to the early diagnosis for PCM.To diagnosis and treat early is important for the prognosis of PCM patients.