心肌致密化不全与扩张型心肌病合并过度小梁化的对比分析  

Comparative Study Between the Patients With Noncompaction of Ventricular Myocardium and Dilated Cardiomyopathy Combining Hypertrabeculation

作　　者：刘双[1] 王明宇[3] 陈丽萍[2] 托丽斯 高璐[1] 刘培培[1] 朱青[1] 孙健[1] 

机构地区：[1]吉林大学第一医院,心血管疾病诊治中心,吉林省长春市130021 [2]吉林大学第一医院心血管中心超声科,吉林省长春市130021 [3]吉林省人民医院神经内科

出　　处：《中国循环杂志》2016年第3期229-232,共4页Chinese Circulation Journal

摘　　要：目的:探讨心肌致密化不全(NVM)与扩张型心肌病(DCM)合并过度小梁化的临床和超声心动图特点,明确对两者鉴别诊断价值。方法:对比分析31例NVM组及50例DCM合并过度小梁化组的性别、年龄、家族史、症状、心电图、脑钠肽(BNP)及超声心动图资料,着重观察两者超声心动图心腔大小、心肌壁、心内膜、彩色多普勒、血液动力学的特点,依据17节段分析法分析小梁化节段数目及程度。结果:(1)DCM合并过度小梁化组心功能分级更差,BNP明显较NVM组高(P<0.05),心脏扩大程度也更明显,差异有统计学意义;(2)NVM组患者小梁化的节段数最多,节段数(9.82±2.02)个,心尖段(第17节段)均受累,非致密化心肌厚度(NC)和致密化心肌厚度(C)比值(NC/C)大(2.84±0.61),NC/C值>2的节段数为(4.12±2.68)个;DCM合并过度小梁化组患者小梁化的节段数少,节段数(5.56±1.56)个,心尖段很少受累,NC/C值小(1.91±0.42),最多有1个节段NC/C值>2。差别均具有统计学意义(P<0.05)。结论:超声心动图是鉴别NVM与DCM的简便、实用、无创性检查手段。左心室心尖段明显呈致密化不全改变及至少2个游离壁节段收缩期的NC/C值>2可诊断NVM,并可与DCM合并过度小梁化相鉴别。Objective： To explore the clinical and echocardiography characteristics between noncompaction of ventricular myocardium（NVM） and dilated cardiomyopathy（DCM） combining hypertrabeculation in order to distinguish NVM from DCM.Methods： Our research included 2 groups of patients： NVM group, n=31 and DCM combining hypertrabeculation group, n=50. The basic information as gender, age, family history, symptoms, ECG, plasma levels of BNP and echocardiography were recorded and examined in all patients; the size of cardiac chambers, myocardium, endocardium and hemodynamics were particularly focused. The trabeculation was analyzed by 17 segments method.Results：（1） Compared with NVM group, the patients in DCM combining hypertrabeculation group had the worse cardiac classification, higher plasma levels of BNP（P0.05） and more obvious cardiac dilatation.（2） The patients in NVM group had the most trabeculation segments（9.82 ± 2.02） and the apical（17th segment） was involved, patients had the higher ratio of noncompacton/compaction（NC/C） as（2.84 ± 0.61）, there were（4.12 ± 2.68） segments with NC/C 2.（3） The patients in DCM combining hypertrabeculation group had the less trabeculation segments（5.56 ± 1.56） and the apical was seldom involved, patients had the lower ration of NC/C as（1.91± 0.42）, there was at most 1 segment with NC/C 2. All P0.05.Conclusion： Echocardiography is a simple, practical and noninvasive method to distinguish NVM from DCM. NVM could be diagnosed by obvious left ventricular apex involvement with NC/C 2 in at least 2 segments of free ventricular walls.

关 键 词：心肌病 扩张型 心肌致密化不全 超声心电描记术 过度小梁化 

分 类 号：R542.2[医药卫生—心血管疾病]