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健康儿童与心肌炎患儿心音三维分析
作者:刘艳萍1 张玉华2 葛明1 李桥2 王明月1 刘毅2 杨力群1 赵玲2 王立琴1 李新2 宋筱华1 周洪军2 毛健荣1 邵庆 
单位:1.济南铁路中心医院,儿科,山东,济南,250001; 2.山东医科大学,生物医学工程研究室,山东,济南,250012
关键词:心肌炎 心音 频谱分析 儿童 
分类号:R540.4, R542.2+1
出版年·卷·期(页码):2000·19·第一期(38-41)
摘要:

目的:通过心音三维分析了解小儿心肌炎的心音特征.方法:对34例健康儿童和26例心肌炎患儿在同一条件下进行心电心音同步采样,将获取的心音信息用计算机三维分析软件从频率、时间、强度三维领域分析研究.结果:心肌炎患儿第二心音(S2)波峰前后60-ms面积与第一心音(S1)面积之比值RTS高于健康儿童,0.05>P>0.01.S2第1谱峰峰值前后5-Hz范围内功率谱曲线所围面积(A1)与0~200-Hz的功率谱曲线所围面积(A2)之比值RF△S低于健康儿童,P<0.001.以频率响应25~200-Hz高频分析收缩期杂音(SM)和舒张期杂音(DM),显示心肌炎患儿SM和DM的RF△S明显高于健康儿童,P≤0.001 .以频率响应0~10-Hz低频分析,其RF△S值低于健康儿童,0.05>P>0.01.结论:心肌炎患儿S1强度明显减弱,S2第1谱峰低频成分减少,SM和DM明显且高频成分增多,SM低频成分减少.

Objective  To study the three  dimensional characteristics of heart sound in children with myocarditis. Methods  The domains of frequency,time and intensity of heart sound in 34 myocarditis children and 26 normal children were sampled and analysed through a computer software of three  dimensional analysis.Results  RT  S of the second sound in time domain is higher,RF    △S   of the first spectral peak of second sound is lower in myocarditis children than that in normal children,the energy ratio of 25~200?Hz to 0~200 Hz of systolic and diastolic murmurs in frequency domain is higher in myocarditis children than that in normal children,but the energy ratio between 0~10 Hz is lower.Conclusion  The intensity of the first sound,the low frequent components of the first peak of the second sound were reduced,the high frequent components of systolic and diastolic murmurs were increased and the low frequent component of systolic murmur was reduced in children with myocarditis.

参考文献:

[1] 胡旭东, 于秀章. 心脏听诊与心音图, 1981
[2] 聂冠群. 正常心音频谱分析, 1983(1)
[3] 李家宜. 小儿病毒性心肌炎诊断标准, 1996(5)
[4] 李桥, 邵庆余. 三维心音图微机分析系统及杂音谱分析, 1993(5)
[5] 徐成斌. 心音图学, 1982
[6] Wirsky I. Clinical assessment of diastolic function, 1990
[7] 舒乃华, 陈灏珠, 赵耐青. 常见喷射性收缩期杂音的时域、频域特征分析, 1988(6) 

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