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目的估测扩张型心肌病肺动脉压并探讨其临床意义。方法用多普勒超声检查２６例扩张型心肌病患儿及２６名配对健康儿。肺动脉压用测三尖瓣最大返流速度及肺动脉血流加速时间（ＡＴ）两种方法估测。结果２６例患儿中２１例有三尖瓣返流，肺动脉收缩压（ＰＡＳＰ）３．２～１０．４ｋＰａ（６．０±１．９ｋＰａ）（２４～７５ｍｍＨｇ，１ｋＰａ＝７．５ｍｍＨｇ）。其中１８例（８６％）＞４ｋＰａ；对照组１４例有可测三尖瓣返流，ＰＡＳＰ均＜４ｋＰａ。患儿组ＡＴ缩短，ＡＴ与右室射血时间比值降低，也提示肺动脉压增高。ＰＡＳＰ与患儿左室短轴缩短分数、心功能低下持续时间及有无心内超声自发显影有关。随诊显示心功能好转者的ＰＡＳＰ较死亡或病情无改善者低，且后者肺动脉压继续增高。结论扩张型心肌病患儿多存在肺动脉高压，用多普勒超声估测的肺动脉压与患儿的病情及临床预后可能有一定的关系。
Objective To evaluate pulmonary artery pressure in patients with dilated cardiomyopathy and to explore its clinical significance. Methods Doppler ultrasound examination of 26 cases of dilated cardiomyopathy and 26 matched healthy children. Pulmonary arterial pressure measured by the maximum tricuspid regurgitation velocity and pulmonary blood flow acceleration time (AT) two methods to estimate. Results Twenty-six of the 26 children had tricuspid regurgitation with pulmonary artery systolic pressure (PASP) 3.2 ~ 10.4kPa (6.0 ± 1.9kPa) (24 ~ 75mmHg, 1kPa = 7.5mmHg). 18 cases (86%)> 4kPa; control group, 14 cases of measurable tricuspid regurgitation, PASP <4kPa. AT group in children with shortening, AT and right ventricular ejection time ratio decreased, also prompted increased pulmonary artery pressure. PASP with shortening of left ventricular short axis in children, the duration of cardiac dysfunction and the presence or absence of spontaneous intracardiac ultrasound imaging. Follow-up showed improved cardiac function PASP than those who died or had no improvement in those with low, and the latter pulmonary hypertension continued to increase. Conclusions There are many pulmonary hypertension in children with dilated cardiomyopathy. Pulmonary arterial pressure estimated by Doppler echocardiography may have a certain relationship with the prognosis and prognosis in children.