缩窄性心包炎的临床及超声心动图特征——附36例病例报告及文献复习.pdfVIP

北 京 大 学 学 报 ( 医 学 版 ) JOURNAL OF PEKING UNIVERSITY(HEALTH SCIENCES) Vo1．39 No．6 Dec．2007 · 论 著 · 缩窄性心包炎的临床及超声心动图特征 — — 附36例病例报告及文献复习 冯新恒，李昭屏，李卫虹，陈宝霞，高 炜 (北京大学第三医院心内科，北京 100083) [摘 要]目的：分析缩窄性心包炎的临床及超声心动图特征。方法：回顾分析我院自1989年10月至2007年6月 临床确诊的缩窄性心包炎36例，分析其临床表现和超声心动图特点。结果：缩窄性心包炎主要临床表现为乏力 (100％)、劳力性呼吸困难(100％)、颈静脉充盈(97％)、肝大(64％)和下肢浮肿(97％)。超声心动图表现为心包 增厚(67％)，左、右心房增大(分别为92％，39％)，室间隔及左心室后壁舒张期异常运动(分别为83％，75％)，二尖 瓣早期充盈异常(93％)，下腔静脉增宽且不随呼吸变化(100％)，组织多普勒显示二尖瓣环舒张早期反常运动增 强。结论：腔静脉系统压力增高有助于缩窄性心包炎的诊断，超声心动图的各项特征性表现对确立诊断有重要价 值。 [关键词]心包炎，缩窄性；超声心动描记术；诊断 [中图分类号]R542．11 [文献标识码]A [文章编号]1671．167X(2007)06-0642-03 Clinical and echocardiographic features of constrictive pericarditis：analysis of 36 ca- ses with literature review FENG Xin-heng，LI Zhao-ping，LI Wei．hong，CHEN Bao．xia，GAO Wei (Department of Cardiology，Peking University Third Hospital，Beijing 100083，China) ABSTRACT 0bjective：To analyze the clinical and echocardiographic features of constrictive pericardi— tis．Methods：Thirty-six patients diagnosed as having constrictive pericarditis from Oct．1989 to Jun． 20o7 were enrolled in this retrospective study．Clinical manifestations and echocardiographic features were analyzed．Results：卟e main clinical manifestations were fatigue，effort dyspnea(100％)，and sign of pressure elevation of vena cava(97％)．Echocardiographic features included thickening of pericardium (67％)，abnormal motion of septal and posterior wall of left ventricle in diastole(83％，75％respective— ly)，left and right atrial enlargement(92％，39％respectively)，early filling changes of mitral flow with respiration(93％)，inferior vena cava dilation and without respiration variation(100％)，mitral annulus paradoxical enhanced motion in early diastole．Conclusion：Clinical manifestations of pressure elevation of vena cava were indicators for diagnosis of constrictive