| 2086例右心增大患者病因回顾性分析与超声诊断 |
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| 引用本文： | 王斌,谢明星,张丽. 2086例右心增大患者病因回顾性分析与超声诊断[J]. 中华医学超声杂志(电子版), 2016, 13(11): 865-871. DOI: 10.3877/cma.j.issn.1672-6448.2016.11.014 |
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| 作者姓名： | 王斌 谢明星 张丽 |
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| 作者单位： | 1. 430000 武汉，华中科技大学同济医学院附属协和医院心血管研究所 超声影像科 湖北省分子影像重点实验室 |
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| 摘 要： | 目的分析采用超声心动图诊断为单纯性右心增大患者的临床病因，为右心增大的超声诊断提供思路。 方法回顾性分析华中科技大学附属协和医院2013年1月至2015年5月2086例单纯右心增大患者的超声图像特征及临床资料，总结右心增大的临床病因。 结果2086例单纯右心增大患者中，先天性心脏病1098例（52.64%），其中简单先天性心脏病804例（38.54%），以房间隔缺损为主674例（32.31%），复杂先天性心脏病294例（14.09%）；先天性心脏病及瓣膜病术后继发右心增大373例（17.88%）；肺心病140例（6.71%）；瓣膜疾病113例（5.42%），其中三尖瓣57例（2.73%），风湿性心脏病36例(1.73%），非风湿性心脏病21例（1.01%），乏氏窦瘤破入右心42例（2.01%），联合瓣膜疾病8例（0.96%），肺动脉瓣关闭不全4例（0.19%）；心肌病30例（1.44%），以致心律失常性右心室心肌病及右心室心肌致密化不全常见；冠心病21例（1.0%）；冠状动脉瘘入右心系统20例（0.96%）；肺栓塞14例（0.67%）；心律失常14例（0.67%）；其他原因265例（12.51%）。 结论引起单纯性右心增大的主要原因为简单先天性心脏病，以房间隔缺损为主，其次依次为先天性心脏病及瓣膜病术后继发、瓣膜疾病、心肌病、冠心病等。
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| 关 键 词： | 超声心动图 右心增大 先天性心脏病 |
| 收稿时间： | 2016-05-25 |
Retrospective analysis of etiology and echocardiography diagnosis in 2086 cases with right heart enlargement |
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| Bin Wang,Mingxing Xie,Li Zhang. Retrospective analysis of etiology and echocardiography diagnosis in 2086 cases with right heart enlargement[J]. Chinese Journal of Medical Ultrasound, 2016, 13(11): 865-871. DOI: 10.3877/cma.j.issn.1672-6448.2016.11.014 |
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| Authors: | Bin Wang Mingxing Xie Li Zhang |
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| Affiliation: | 1. Department of Ultrasound, Union Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430000, China |
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| Abstract: | ObjectiveTo analysis the pathogenies which result in the simple enlargement of right heart, to provide ideas about the Echocardiograph diagnosis of this disease. MethodsThis study retrospectively analyzed 2086 patients diagnosed as right heart enlargement by Echocardiography in the Affiliated Union Hospital of Huazhong University of Science and Technology from January 2013 to May 2015, include the characteristics of echocardiography image and clinical data, then summarized the clinical pathogenies of right heart enlargement. ResultsA total of 2086 cases were collected, 1098 cases were congenital heart diseases (52.64%), including 804 cases of simple congenital heart diseases (38.54%), ASD 674 (32.31%), 294 cases of complex congenital heart diseases (14.09%). Three hundred and seventy three cases of secondary enlargement after operation of Congenital heart diseases and valvular diseases (17.88%). One hundred and forty cases of pulmonary heart diseases (6.71%). One hundred and thirteen cases of valvular heart disease (5.42%), including 57 cases of three tricuspid valve diseases (2.73%), 36 cases of rheumatic heart diseases (1.73%), 21 cases of non-rheumatic heart diseases (1.01%), 42 cases of sinus of Valsalva aneurysm ruptured into the right heart (2.01%), 8 cases of combined valvular diseases (0.96%), 4 cases of pulmonary valve regurgitation (0.19%). 30 cases of cardiomyopathy (1.44%), mainly of arrhythmogenic right ventricular cardiomyopathy (ARVC) and noncompaction of right ventricular myocardium (NVM) . Twenty one cases of coronary heart diseases (1.00%). Twenty cases of Coronary artery fistula into the right heart, (0.96%). Forteen cases of pulmonary embolism (0.67%). Forteen cases of arrhythmia (0.67%). Two hundred and sixty five cases of the other reasons (12.51%). ConclusionsThe main clinical pathogeny which results in simple enlargement of right heart was simple congenital heart disease, especially ASD, followed by the secondary enlargement after operation of congenital heart diseases and valvular heart diseases, valvular heart diseases, cardiomyopathy and coronary heart disease et al. |
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| Keywords: | Echocardiography Right heart enlargement Diagnosis thinking |
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