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目的分析缩窄性心包炎(CP)二种少见的超声表现及临床意义。方法1981-04-2004-04回顾分析广东省心血管病研究所187例CP患者的超声资料。重点观察左室射血分数(LVEF)及吸气相二尖瓣E峰(VEi)较呼气相(VEe)的下降率VER=(VEe-VEi)/VEe。结果大部分病人符合CP一般超声改变。但发现二种少见的超声征象。(1)14例(7.49%)CP患者LVEF<0.50(0.45±0.42)。心包钙化明显甚或嵌入心肌。(2)48例窦性心律CP患者行多普勒超声检查,10例(20.83%)VER<25%(均值14.84%)并见心包广泛粘连、挛缩、大片缩窄环形成。结论CP患者LVEF下降及二尖辩血流速度吸气相较呼气相下降<25%时,提示心包病变严重。范围广泛,应引起临床高度重视。
Objective To analyze the two rare manifestations and clinical significance of constrictive pericarditis (CP). Methods A retrospective analysis was performed on 187 cases of CP in Guangdong Institute of Cardiovascular Diseases from January 1981 to April 2004. The VER = (VEe-VEi) / VEe was mainly observed in left ventricular ejection fraction (LVEF) and inspiratory mitochondrial E-peak (VEi) and exhalation phase (VEe) The results of most patients with CP general ultrasound changes. But found two rare signs of ultrasound. (1) LVEF <0.50 (0.45 ± 0.42) in 14 cases (7.49%) CP patients. Pericardial calcification significantly or even embedded in the myocardium. (2) 48 cases of sinus rhythm CP patients underwent Doppler ultrasound examination, 10 cases (20.83%) VER <25% (mean 14.84%) and see the pericardial adhesions, contracture, large ring narrowing. Conclusions The decrease of LVEF in CP patients and the decrease of expiratory blood flow velocity in two-pronged blood flow velocity were less than 25%, suggesting that the pericardial lesions were severe. A wide range of clinical should pay close attention.