克山病患者自我治疗疗效的超声心动图评价

目的 应用超声心动图观察克山病患者自我治疗前后心脏结构及功能的变化,评价克山病患者自我治疗的疗效.方法 在自我治疗前及治疗3、6个月时对31例克山病患者进行超声心动图检查.观察左房内径(LAd)、左室舒张末期内径(LVEDd)、室间隔舒张末期厚度(IVSTd)、左室后壁舒张末期厚度(LVPWTd)、左室质量(LVM)、左室质量指数(LVMI)、左室射血分数(LVEF)和二尖瓣舒张早、晚期血流速度峰比值(E/A).结果 治疗3个月时患者LAd[(35.8±5.1)mm]及LVPWTd[(9.3±1.0)mm]较治疗前[(37.0±5.0)、(9.9±1.2)mm]明显降低(P<0.05);治疗6个月时患者LAd[(34.5±5.0)mm]、IVSTd[(9.5±1.3)mm]、LVEDd[(50.2±7.7)mm]、LVPWTd[(8.7±1.1)mm、LVM[(196.1±87.2)g]和LVMI[(126.5±56.4)g/m2]与治疗前[(37.0±5.0)、(10.2±1.5)、(51.3±8.1)、(9.9±1.2)mm、(230.4±95.5)g、(144.0±54.6)g/m2]和治疗3个月时[(35.8±5.1)、(10.2±1.4)、(51.1±8.1)、(9.3±1.0)mm、(219.4±82.5)g、(136.8±50.0)g/m2]比较均明显降低(P<0.05);E/A及LVEF值在治疗3个月时[1.0±0.5、(59.4±13.3)%]较治疗前[0.9±0.5、(58.1±15.6)%]有所增高,在治疗6个月时[1.0±0.4、(60.7±13.6)%]进一步增高,两两比较差异均无统计学意义(P0.05).结论 克山病患者经过自我治疗后,左室重构受到限制,并发生了逆转,心功能得到了相应改善.超声心动图为克山病患者自我治疗疗效的评价提供了有效的方法.

Evaluation of effects of self-treatment on patients with Keshan disease by echocardiography

Objective To observe the change in cardiac shape and heart function and evaluate the effect of self-treatment on patients with Keshan disease by echocardiography. Methods To check the 31 patients with Keshan disease before the self-treatment, and follow them up in the 3rd and 6th months after self-treatment by echocardiography. The left atrium diameter(LAd), left ventricular end-diastolic diameter(LVEDd), the thickness of interventricular septum in end-diastolic(IVSTd), the thickness of LV posterior wall in end-diastolic (LVPWTd), left ventricular mass(LVM), left ventricular mass index(LVMI), left ventricular ejection fraction(LVEF) and mitral valve flow E/A ratio(E/A) were measured. Results The LAd[(35.8±5.1)ram] and LVPWTd[(9.3±1.0)mm] obviously decreased in the 3rd month after serf-treatment compared with prior self-treatment [ (37.0±5.0), (9.9± 1.2)mm](P<0.05). The LAd[(34.5±5.0)mini, IVSTd[(9.5±1.3)mm], LVEDd[(50.2±7.7)mm], LVPWTd [(8.7±1.1)mm], LVM[(196.1±87.2)g] and LVMl[(126.5±56.4)g/m2] obviously decreased in the 6th month after self-treatment compared with prior self-treatment [(37.0±5.0), (10.2±1.5), (51.3±8.1), (9.9±1.2)mm, (230.4±95.5)g, (144.0±54.6)g/m2] and in the 3rd month after self-treatment [(35.8±5.1)mm, (10.2±1.4) ram, (51.1±8.1)nun, (9.3±1.0)mm, (219.4±82.5)g, (136.8±50.0)g/m2] (P<0.05). The results of the mitral valve flow E/A ratio and LVEF in the 3nt month after self-treatment [1.0±0.5, (59.4±13.3)%] were increased compared with the prior self-treatment[0.9±0.5, (58.1±15.6)%], and the results in the 6th month after self-treat- ment[ 1.0±0.4, (60.7±13.6)%] were further inereased compared with before, but there was no signifieant differ- ence(P0.05). Conclusions Self-treatment of Keshan disease patients can improve the heart function by pre- venting left ventrieular remodeling and reversing. Echocardiography can be used as an essential technique to evalu- ate the effect of self-treatment on Keshan disease patients.