自动室壁分区运动及全方位M型超声心动图对扩张型心肌病与缺血性心肌病的对比分析  

Comparative analysis of dilated and ischemic cardiomyopathy by using two dimensional echocardiography with automated segmental motion analysis and free angle model

作　　者：赖小今[1] 宋兆琼 邓旦[1] 朱峻[2] 李树森[1] 陶杰[1] 廖明松[1] 梁燕[1] 

机构地区：[1]成都军区总医院超声科,610083 [2]成都军区总医院心内科,610083 [3]四川省资阳市第一人民医院超声科

出　　处：《中华超声影像学杂志》2007年第7期589-592,共4页Chinese Journal of Ultrasonography

基　　金：四川省卫生厅科学研究基金资助项目（040077）

摘　　要：目的探讨二维彩色多普勒超声结合自动室壁分区运动（ASAM）及全方位M型超声心动图（FAM）技术对比分析评估扩张型心肌病（DCM）与缺血性心肌病（ICM）的临床意义。方法经冠状动脉造影诊断明确的36例ICM与38例DCM患者应用二维彩色多普勒结合ASMA-FAM检查,对比两组心脏形态学、室壁运动状态、血流动力学、心功能等特点。结果DCM组心脏呈普遍扩大,室壁运动呈弥漫性减弱,室壁心肌运动的面积变化分数（FAC）普遍〈30%,瓣膜反流发生率高且程度重,早期收缩功能显著降低而舒张功能呈“正常化”;ICM组心脏多呈局限扩大,室壁运动呈节段性障碍,FAC高低不均,瓣膜反流发生率较低且程度较轻,早期舒张功能障碍而收缩功能可基本维持正常。结论二维彩色多普勒结合ASMA-FAM可为临床鉴别DCM与ICM提供较为可靠的依据。Objective To compare analysis of dilated cardiomyopathy（DCM） and ischemic cardiomyopathy （ICM） by using two dimensional echocardiography（2DE） with automated segmental motion analysis （ASMA） and free angle model（FAM） to explore it＇s application value in differential diagnosis of DCM and ICM. Methods Thirty-six cases with ICM and 38 cases with DCM which were be definite diagnosed by coronary arteriography were received 2DE with ASMA-FAM. Then the characteristics of DCM and ICM in cardiac morphology, wall motion state, hemodynamics, and cardiac function were analyzed. Results The heart of DCM enlarged obviously, the wall motion decreased widely, and the fractions of area changing（FAC） were lower 30% generally, and the incident rates of cardiac valvular regurgitation were higher, and it＇s degree were heavy, and the cardiac function were marked by lower ventricular systolic function and ＂normal＂ ventricular diastolic function. The heart of ICM enlarged regionally,the wall motion decreased segmentally, which were regional wall motion abnormality,and the FAC were lower or higher,and the incident rates of cardiac valvular regurgitation were lower,and it＇s degree were light,and the cardiac function were mainly characterized by ventricular diastolic disfunction, which may occur with normal systolic function. Conclusions 2DE with ASMA - FAM may be an accurate confidence and noninvasive method for differential diagnosis of DCM and ICM.

关 键 词：超声心动描记术 心肌病 扩张型 心肌缺血 

分 类 号：R686[医药卫生—骨科学]