扩张型心肌病与冠心病心衰患者心脏结构和左室功能对比分析

目的 对扩张型心肌病（DCM）与冠心病（CHD）心衰患者心脏结构和功能特点进行分析，为临床提供鉴别诊断以及评价预后的依据。方法 将72例患者分成扩张型心肌病组（DCM组，n=38）和冠心病心衰组（cHD组，n=33）进行超声心动图检查，获得心脏结构和功能的多项参数。结果DCM组左房内径（LAD）、舒张末期室间隔厚度（IVS）、左室后壁厚度（LVPW）、左室内径（LVD）、右室内径（RVD）和左室射血分数（EF）、左室短轴缩短率（FS）、二尖瓣一室间隔间距（EPSS）与CHD组比较均有显著性差异（P〈0．05）。DCM组的二尖瓣返流（MR）程度均明显高于CHD组。DCM组以弥漫性室壁运动障碍为其特征，CHD组则多表现为节段性的室壁运动异常。结论 超声心动图检查能为DCM与CHD心衰患者的鉴别诊断以及评价预后提供有力的依据。

Comparative Analysis of Dilated Cardiomyopathy and Coronary Heart Disease with Heart Failure in Heart Structure and Left Ventricular Function

Objective To investigate the characteristics of heart structure and left ventricular function in DCM and CHD with HF and provide a clinical basis for differential diagnosis and prognostic evaluation.Methods 72 patients were divided into dilated cardiomyopathy group(DCM,n=38)and coronary heart disease with HF group(CHD,n=33).All patients were measured by echocardiography.Results Left atrium internal diameter(LAD),Interventricular sepals thickness(IVS),left ventricular posterior wall thickness(LVPW),left ventricular internal diameter(LVD),right ventricular internal diameter(RVD)and left ventricular ejection fraction(EF),left ventricular fraction shortening(FS),E point septum separation(EPSS)in DCM group were significantly difference when compared with CHD group(P<0.05),the extent of mitral regurgitation(MR)in DCM group were more serious than that of CHD group(P<0.05).Abnormalities of diffuse wall motion was the characteristic of the patients with DCM,but CHD patients mostly showed abnormalities of regional wall motion.Conclusions Echocardiography can provide a powerful clinical basis for differential diagnosis and prognostic evaluation of DCM and CHD with HF patients.