彩色多普勒诊断非瓣膜病二尖瓣返流及临床意义

目的评价彩色多普勒诊断非瓣膜病二尖瓣返流的意义。方法用彩色多普勒超声对冠心病、高心病、扩心病、肺心病、甲亢及糖尿病、尿毒症性心脏病进行检查。测量返流程度（Ｈｅｌｍｃｋｅ法）和左室内径（ＬＶ）。从中选出１１５例具有病理性返流而无瓣膜病患者进行分析、对比。结果有返流的ＣＨＤ患者，３７％ＬＶ增大（５２．７±４．０），其增大程度比高心病（６１．７±４．２）、ＤＣＭ（６９．１±６．８）、尿毒症心脏病（６２．７±６．８）有显著差异（Ｐ＜０．０５），增大百分率亦显著不同（Ｐ＜０．０５）。结论根据返流可以判断各病变时期，ＣＨＤ多出现在病变早期，返流程度可轻可重。高心病，ＤＣＭ，尿毒症、甲亢、糖尿病心脏病多出现在病变晚期，左室扩大后，且多为轻度返流

Clinical Significance of Color Doppler Ultrasonography in Diagnosis of Mitral Regurgitation in Non volvular Disease

Objective To study the clinical significance of color Doppler ultrosonography in diagnosis of non valvular mitral regurgitation(MR).Method The patients with coronary heart disease (CHD),hypertensive heart disease (HHD),dilated cardiomyopathy(DCM),cor pulmonale,hyperthyroid,diabetic and uremic heart disease were examined by the color Doppler ultrasonography.The degree of MR (Helmcke method) and the internal diameter of left ventricle (LV) were measured.115 cases with pathologic MR of non valviular disease were analysed and contrasted.Results 63(37.5%) of MR patients with CHD had dilatation of LV(52.7±4.0)as compared with hypertensive heart disease (61.7±4.2),DCM (69.1±6.8) and uremic heart disease (62.5±6.8),their dilatation degree had significant differences (P<0.05)。The percentage of dilatation were also significant (P<0.05).There was no dilatation of LV in cor pulmonale.To the extent of regurgitation,the patients with middle degree of CHD were 23% and the severe patients were 5.4%.Conclusions Each disease phase could be judged based on MR,the CHD appears more frequently in its early period and the degree of regurgitation may light or severe.Hypertensive,uremic, hyperthyroid, diabetic heart disease and DCM appear more frequently in their late period and usually after dilatation of LV,but mainly were light regurgitation.