扩张型心肌病合并左心室血栓的超声心动图分析  

Echocardiographic characters of left ventricular thrombus in patients with dilated cardiomyopathy

作　　者：余瑕[1] 黄洁[2] 林仙方[1] 

机构地区：[1]台州医院超声科,浙江台州317000 [2]台州医院心内科,浙江台州317000

出　　处：《临床荟萃》2011年第4期296-297,300,F0002,共4页Clinical Focus

摘　　要：目的探讨扩张型心肌病(DCM)患者合并左心室附壁血栓的超声心动图特征。方法回顾性分析188例DCM患者超声心动图资料,根据左心室有无血栓形成分为无血栓组和有血栓组,对两组患者的超声心动图检查结果进行比较。结果血栓组共18例(9.6%),与无血栓组相比,该组患者左心室射血分数(LVEF)及左心室短轴缩短率(LVFS)较低,(28.9±9.8)%vs(36.4±6.6)%(、11.3±3.3)%vs(17.1±5.2)%,左心房内径(LAD)及左心室收缩末期内径(LVIDs)较大,(48.6±4.1)mm vs(43.2±5.1)mm、(61.7±4.7)mm vs(51.8±5.3)mm;中重度二尖瓣反流(MR)发生率较低(22.2%vs 70.5%,均P<0.01)。结论 DCM患者LAD及LVIDs较大、左心室心肌收缩力下降明显者易导致左心室附壁血栓形成;二尖瓣中重度MR有对抗左心室血栓形成的作用。Objective To investigate the echocardiographic characters of left ventricular thrombus in patients with dilated cardiomyopathy（DCM）.Methods We analyzed the data of 188 patients with DCM.The patients were divided into two groups：patients with left ventricle thrombus group and patients without left ventricle thrombus group.We sought to compare the transthoracic echocardiographic outcome of these two groups.Results We identified 18 patients（9.6%） with left ventricle thrombus.There were significant statistical difference in some factors between two groups,such as left ventricle ejection fraction（28.9±9.8）% vs（36.4±6.6）%,fractional shortening（11.3±3.3）% vs（17.1±5.2）%,internal diameter of systolic left ventricle（61.7±4.7）mm vs（51.8±5.3） mm,and left atrium（48.6±4.1） mm vs（43.2±5.1） mm（P0.01）.Moderate-severe mitral valve regurgitation（22.2% vs 70.5%）more frequently occurred among patients without left ventricle thrombus（P0.01）.Conclusion Our findings suggest that some factors may indicate a higher risk of thrombus formation,such as the left ventricular systolic disfunction,enlargement of internal diameter of systolic left ventricle and left atrium.Moderate-severe mitral valve regurgitation may prevent mural thrombus formation within the left ventricle.

关 键 词：心肌病 扩张型 血栓形成 心室 超声心动描记术 

分 类 号：R542.1[医药卫生—心血管疾病]