超声心动图对心内膜弹力纤维增生症患儿血流动力学变化的分析研究

目的 应用二维多普勒超声心动图技术对心内膜弹力纤维增生症(EFE)患儿的血流动力学变化进行分析研究.方法 超声心动图检查EFE患者32例,平均年龄(1.5±0.6)岁,正常对照(NC)组30例.结果 EFE组与NC组比较,各指标均有显著性差异(P<0.001),超声参数的特点为舒张期左房内径(LADd)、左室内径(LVDd)、室间隔厚度(IVSTd)、左房射血力(LAF)、室壁应力指数(ws I～Ⅲ)、峰值速度A(A峰)及等容舒张时间(IRTs)增大;但射血分数(EF)、心脏指数(CI)、心室短轴缩短率(FS)、峰值速度E(E峰)、峰值速度比(E/A)、舒张早期快速充盈加速度(AC)、1/3及1/2充盈分数(1/3FF、1/2FF)及标准化充盈分数(NPFR)降低;将EFE组治疗前后比较除IVSd、A峰及IRTs无显著性差异(P>0.05)~b,其余各指标均有显著性差异(P<0.01-0.001).结论 EFE患儿可出现房室腔扩大、心脏收缩和舒张功能降低、室壁应力增大及左房射血力代偿性增加;而二维多普勒超声心动图对于EFE患儿的早期诊断、疗效评价及预后估测都有极为重要的临床价值.

Study on hemodynamie changes of children with endocardial fibroelastosis by echocardiography

Objective To analyse the hemodynamic changes of children with endocardial fibroelastosis (EFE)by two dimensional echocardiography.Methods Echocardiography examination was performed in 32 childrenwith EFE [(1.5±0.6)year]and 30 normal control(NC)group.Results The parameters of echocardiography in the EFE group were significantly different from those NC group(P<0.001),such aS left atrial diameters(LADd),left ventricular diameters(LVDd),interventricular septal thickness(IVSTd),left atrial ejection force(LAF),wall stress indexes(ws I～IlI),peak velocity A,and isovoltunic relaxation time(IR]rS) were increased,but ejection fraction(EF),cardiac index(CI),fractional shortening(FS),E/A ratio,early phase diastolic acceleration(AC),1/3 filling fraction(1/3FF),1/2 filling fraction(1/2FF),and normalized Deak filling rate(NPFR)were decreased in EFE group.In comparison with those before treatment,all of hemodynamic parameters after treatment(except for IVSTd,A and IRTs)were significantly changed(P<0.01.r P< 0.001).Conclusions Left atrial-ventricular dilation,and systolic and diastolic function were decreased.but left ventricular wall stress and left atrial ejection force were increased in children with EFE,CDFI possesses a significant clinical worth for early diagnosis,therapeutic and prognosis evaluation in patients with EFE.