风湿性心脏炎患儿的超声心动图评价

目的 了解风湿性心脏炎患儿心脏受累情况，评价超声心动图对本病的价值。方法 回顾性总结分析1980－01－1999－12收治的216例风湿性心脏炎患儿的心电图及超声心动图特点，比较两诊断到肥大的敏感性。结果 158例（73．1％）有心电图异常，以房室传导阻滞最多见（65例，41．1％），超声心动图检查显示152／154例（98．7％）有不同程度的房室扩大，以左房大最多见（94例，61％），所有患儿心脏瓣膜均有改变，主要表现为二尖瓣的返流，增厚及狭窄和主动脉瓣返流，以单纯二尖返流最多见（103例，66．9％），治疗后复查心脏超声二尖瓣返流可消失，心脏超声检查诊断左房大，左室大的敏感性明显优于心电图。结论 超声心动图检查对儿童风湿性心脏炎的诊断及观察治疗效果具有重要价值。

Echocardiographic Evaluation of Children with Rheumatic Carditis

Objective To evaluate the condition of involved heart and the value of echocardiography in children with rheumatic carditis (RC).Methods Electrocardiogram (ECG) and echocardiography data were retrospectively analyzed and the diagnostic sensitivities of cardiac enlargement by the two methods were compared in 216 children with RC in Shandong Provincial Hospital during the period of January 1980 to December 1999.Results Abnomal ECG were found in 158 cases (73.1%) and atrioventricular block (AVB) was the most common finding (65 cases,41%);Echocardiographic examinations perdormed before treatment in 154 cases showed that 152 cases(98.7%) had varying degress of cardiac enlargement,in which enlargement of left atrium(LA) constitute the majority (94 cases,61%),changes of cardiac valves were found in all choldren,mainly displaying as mitral regurgitation (MR),thickening and stenosis and sortic regurgitation,in which MR ranks first(103 casesm66.9%).MR can disappear after regular anti-rheumatic therapy for 12 weeks.The diagnostic sensitivity of enlargement of ECG.Conclusion Echocardiographic examination plays an important role in the diagnosis and follow-up of rheumatic carditis(RC) in children.