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目的比较左右心室长轴方向收缩速度和最大耗氧量在判断扩张型心肌病(DCM)患者预后方面的价值。方法对42例 DCM 患者长期进行常规超声、组织多普勒检查、心肺功能测定和临床随访。根据预后将患者分为两组:A 组为病情加重组18例,B 组为病情稳定组24例。应用运动试验测定两组患者最大耗氧量(VO_(2max))。应用组织多普勒显像方式于心尖四腔观分别检测左右心室侧壁和室间隔的瓣环处、乳头肌水平及二者中点的等容收缩期和射血期速度,进行组间比较,分析其判断患者预后的价值,并与 VO_(2max)进行比较。结果病情加重组的多个心室收缩速度均低于病情稳定组(P<0.05),并且对判断 DCM 预后有较高的敏感性和特异性,存在不依赖于 VO_(2max)的独立预测价值。结论组织多普勒显像检测左右心室收缩速度是判断 DCM 预后的独立预测因子。
Objective To compare the value of systolic velocity and maximal oxygen consumption in the long axis of right and left ventricles in determining the prognosis of patients with dilated cardiomyopathy (DCM). Methods Long-term routine ultrasound, tissue Doppler examination, cardiopulmonary function measurement and clinical follow-up were performed in 42 patients with DCM. According to the prognosis, the patients were divided into two groups: group A was aggravated in 18 cases, group B was stable in group 24 cases. The maximal oxygen consumption (VO_ (2max)) in both groups was determined by exercise test. Tissue Doppler imaging was used to detect the systolic and ejection velocity of left and right ventricular wall and ventricular septum, papillary muscle, The value of judging the prognosis of patients was analyzed and compared with VO 2max. Results The rates of multiple ventricular contraction in patients with exacerbations were lower than those in patients with stable disease (P <0.05), and were more sensitive and specific in judging the prognosis of DCM. There was independent predictive value independent of VO_ (2max). Conclusions Tissue Doppler imaging to measure left and right ventricular systolic velocity is an independent predictor of DCM prognosis.