心电图联合超声心动图在心肌病类型鉴别中的应用  

Application of electrocardiogram combined with ultrasonic cardiogram in identifying types of myocardiopathy

作　　者：张秋丽[1] 孟宪慧[2] 高雪梅[3] 王玉玲[4] 刘淑华[5] 

机构地区：[1]河北省秦皇岛市第一医院功能检查科,河北秦皇岛066000 [2]河北省秦皇岛市第一医院感染管理处,河北秦皇岛066000 [3]河北省秦皇岛市第一医院手术部,河北秦皇岛066000 [4]河北省秦皇岛市第一医院血液科,河北秦皇岛066000 [5]河北省秦皇岛市第一医院心内科,河北秦皇岛066000

出　　处：《实用临床医药杂志》2016年第13期8-10,共3页Journal of Clinical Medicine in Practice

基　　金：中国高校医学期刊临床专项资金(11527737)

摘　　要：目的探讨心电图(ECG)联合超声心动图(UCG)在临床鉴别诊断心肌病类型中的应用价值。方法选取确诊的扩张性心肌病患者66例(Dc组)和缺血性心肌病患者62例(Ic组),2组患者均进行ECG联合UCG检查,观察心功能等检测结果、心脏形态变化及瓣膜返流情况差异。结果 Dc组各腔室扩大程度、二尖瓣E点至室间隔间距及Rv6/Rmax显著高于Ic组,左室射血分数、每搏量显著低于Ic组(P<0.05);Dc组形态变化以弥漫性运动障碍(100.00%)和左室呈球形运动(87.88%)为主,Ic组以室壁矛盾运动(93.55%)及左室拱门形运动(80.65%)为主,差异有统计学意义(P<0.05);2组存在多种瓣膜返流并存状况,且均以二尖瓣为主(P>0.05),Dc组主动脉瓣膜、肺动脉瓣膜及三尖瓣膜的返流几率显著高于Ic组(P<0.05)。结论扩张型和缺血型心肌病患者在ECG联合UCG检查中存在显著特征差异,可为鉴别诊断提供参考。Objective To explore the application of electrocardiogram （ECG） combined with ultrasonic cardiogram （UCG） in clinical identification and diagnosis of types of myocardiopathy. Methods A total of 66 patients diagnosed as dilated eardiomyopathy （ De group） and another 62 patients with ischemic cardiomyopathy （Ic group） were selected. Both groups received ECG and UCG examinations, and the detection results of cardiac function, cardiac morphologic changes and the difference of valvular reflux conditions were observed. Results Dc group was markedly higher in the enlarged severity of each cardiac cavity, the distance from E point of bicuspid valve to interventricular septum （IVS） and Rv6/Rmax, but was evidently lower in left ventrieular ejection fraction （LVEF） and stroke volume （SV） than Ic group （ P 〈 0.05 ） ; The morphological changes in De group mainly included diffuse dyskinesia （100.00%） and spherical motion of left ventricle （87.88%）, and those in Ic group included paradoxical movement of ventricular walls （93.55%） and arch-like motion of left ventricle （80.65%）, and the differences were significant （ P 〈 0.05 ） ; Both groups had coexistence of multiple valvular reflux, especially in bicuspid valve （P 〉 0.05 ） , but Dc group was notably higher than Ic group in the reflux rates of aorta valve, pulmonary artery valve and tricuspid valve （P 〈 0.05 ）. Conclusion There are significant differences in the characters of dilated and ischemic cardiomyopathy according to ECG combined with UCG examinations, so the combined examinations can provide references for the identification and diagnosis of different cardiomyopathy.

关 键 词：扩张型心肌病 缺血型心肌病 心电图 超声心电图 

分 类 号：R542.2[医药卫生—心血管疾病]