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目的研究室间隔组织多普勒舒张期的多相波对缩窄性心包炎的诊断价值。方法选取2000—2011年完成的30例通过手术、病理证实的缩窄性心包炎患者为观察组,对其病例资料进行回顾分析。选取30例正常人作为对照组。观察组术前及对照组均完成超声心动图、组织多普勒成像及心脏磁共振成像(MRI)检查,对两组在舒张期的室间隔组织多普勒特征进行分析。结果观察组符合典型超声表现30例,对照组0例,差异有统计学意义(P<0.05)。心包厚度检查中观察组MRI显像上心包厚度大于3 mm,28例符合,2例不符合。观察组患者的室间隔组织多普勒频谱均出现一个明显的向反方向的反弹波R,在舒张早期E波后,组成了由Ew、R、Aw或含有更多波形的多相波,对照组均无此波形出现。结论缩窄性心包炎患者的室间隔组织多普勒舒张期有特征性的多相波,可用于诊断缩窄性心包炎。
Objective To study the diagnostic value of polyphase wave of diastolic ventricular septum on constrictive pericarditis. Methods Thirty cases of constrictive pericarditis confirmed by surgery and pathology were selected as the observation group from 2000 to 2011. The data of the cases were retrospectively analyzed. 30 normal subjects were chosen as the control group. Echocardiography, Tissue Doppler imaging and cardiac magnetic resonance imaging (MRI) were performed in the observation group before surgery and in the control group respectively. The characteristics of Doppler tissue at the diastolic septum were analyzed. Results The observation group met the typical ultrasound findings in 30 cases, the control group of 0 cases, the difference was statistically significant (P <0.05). In the pericardial thickness examination, the pericardial thickness of the observation group was greater than 3 mm on MRI, 28 cases were consistent, and 2 cases did not. In the observation group, the Doppler spectrum of the interventricular septum showed a significant rebound wave R in the opposite direction. After the early E-wave of diastole, a polyphase wave composed of Ew, R, Aw or more waveforms was formed, and the control None of the waveforms appear in the group. Conclusion Constrictive pericarditis in patients with ventricular septal Doppler diastolic characteristic polyphase wave can be used to diagnose constrictive pericarditis.