超声心动图在围生期心肌病中的预测价值分析

目的：探讨超声心动图在围生期心肌病中的预测价值。方法选取产科住院部收治的围生期心肌病患者79例，根据患者出院后1年回院纽约心脏协会（ NYHA）心功能分级评定结果将患者分为2组，其中NYHAⅠ级作为恢复良好组（ n ＝45），NYHAⅡ～Ⅲ级作为恢复不良组（ n ＝34），比较2组患者首次检查超声心动图参数左心室舒张末期内径（ LVEDD）、左心室收缩末期内径（ LVESD）、左心室射血分数（ LVEF）、左心室短轴缩短率（ LVFS）、舒张早期与舒张晚期血流过度比值（ E／A）]、左心室舒张功能障碍、心包积液（ PE）、左心室附壁血栓、二三尖瓣反流，肺动脉高压（ PH）与各瓣膜口关闭不全的情况。结果恢复良好组LVEDD，LVESD与E／A水平明显低于恢复不良组（ P＜0．05），LVEF、LVFS明显高于恢复不良组（P＜0．05）。恢复良好组左心室舒张功能障碍、PE、左心室附壁血栓、二三尖瓣反流与PH发生率均明显低于恢复不良组（P＜0．05）。恢复良好组PI、AI、TI与MI检出率均明显低于恢复不良组（P＜0．05）。结论首次检查超声心动图参数、左心室舒张功能障碍、左心室附壁血栓，肺动脉高压与各瓣膜口关闭不全等情况均有助于准确预测围生期心肌病的预后状况。

Predictive value of echocardiography in peripartum cardiomyopathy

Objective To investigate the predictive value of echocardiography in peripartum cardiomyopathy . Methods Seventy-nine patients with peripartum cardiomyopathy who were admitted and treated in department of obstetrics of our hospital from January 2013 to January 2015 were divided into two groups according to heart function classification assessment criterion instituted by NYHA ( the examination results in one year after discharging from hospital ): well recovery group ( NYHAⅠ, n =45 ) and bad recovery group ( NYHAⅡ~Ⅲ, n =34 ) .The echocardiographic parameters in the first examination including left ventricular end -diastolic dimension ( LVEDD) , left ventricular end -systolic dimension LVESD , left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), diastolic blood flow velocity ratio (E/A),left ventricular diastolic dysfunction (LVDD),pericardial effusion (PE),left ventricular mural thrombus,mitral tricuspid valve regurgitation,pulmonary hypertension ( PH) and valve mouth incompetence were observed and compared between two groups.Results The levels of LVEDD, LVESD, E/A in well recovery group were significantly lower than those in bad recovery group ( P <0.05), however, the levels of LVEF and LVFS were significantly higher than those in bad recovery group ( P <0.05).The LVDD,PE,left ventricular parietalthrombus,mitral tricuspid valve regurgitation, incidence rates of PH in well recovery group were significantly lower than those in bad recovery group ( P <0.05), and the levels of PI,AI,TI and MI detection rate in well recovery group were also significantly lower than those in bad recovery group ( P <0.05). Conclusion The first examination results of echocardiographic parameters including LVDD , left ventricular parietalthrombus , PH and valve mouth incompetence are helpful to predict exactly the prognosis of patients with peripartum cardiomyopathy .