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本文比较观察190例冠心病患者和20例健康人的心音图变化,其主要表现可小结如下:1.心音的变异:S_1:本文冠心病组S_1减弱,占51.05％,其中心梗病人则有90.0％减弱,若合并乳头肌功能不全或二脱时,S_1可增强。S_2:可呈反常分裂。S_3:18.42％患者心尖区可录到S_3,而健康人组仅10％录到低频、低幅S_3。S_4:66.84％患者可录到S_4,心梗患者则90.91％可录到,且S_4—S_1间距>70ms。健康人组S_4检出率仅20％,且S_4—S_1<70ms。以上表明冠心病患者S_4检出率明显高于健康人。2.冠心病杂音的特点:冠心病组83.69％可录到杂音,其中收缩期杂音占78.95％,舒张期杂音占7.37％。收缩期杂音多在心尖、心前区,以中、高频,低、中幅,早、中期多见。伴乳头肌功能不全或二脱者,杂音可是菱型、全收缩期杂音。舒张期杂音主要在主动脉瓣区或付主动脉瓣区,呈中、高频,中、低幅,早、中期。本文冠心病心音图改变进行较全面描述并加分析讨论。笔者认为通过冠心病者心音及杂音的观察,结合临床对冠心病的诊断、心功能的判定、药物疗效的评价,以及预后的估计,均具有实际临床意义。
In this paper, we compared the changes of phonocardiogram in 190 patients with coronary heart disease and 20 healthy people. The main findings are summarized as follows: 1. The variation of heart sounds: S_1: S_1 is weakened in CHD group, accounting for 51.05% 90.0% weakened, if combined with papillary dysfunction or two off, S_1 can be enhanced. S_2: can be abnormally split. S_3: 18.42% patients recorded apical area S_3, while only 10% of healthy people recorded low-frequency, low amplitude S_3. S_4: 66.84% of patients can record S_4, 90.91% of myocardial infarction patients can be recorded, and S_4-S_1 spacing> 70ms. Healthy people group S_4 detection rate of only 20%, and S_4-S_1 <70ms. The above shows that the detection rate of S 4 in patients with coronary heart disease was significantly higher than that in healthy people. 2. Coronary heart disease murmur features: 83.69% of coronary heart disease group can be recorded murmurs, of which systolic murmur accounted for 78.95%, diastolic murmur accounted for 7.37%. Systolic murmur and more in the apex, precordial area to medium and high frequency, low, medium amplitude, early, mid-term more common. Accompanied by papillary dysfunction or two off, noise, but diamond, all systolic murmur. Diastolic murmur mainly in the aortic valve area or pay aortic valve area, was in the high frequency, medium and low amplitude, early, mid-term. Coronary heart disease in this paper changes the phonocardiogram more fully described and analyzed. I believe that through the observation of heart sounds and noise in patients with coronary heart disease, combined with clinical diagnosis of coronary heart disease, heart function determination, evaluation of drug efficacy, and prognosis of the estimates, are of practical clinical significance.