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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 3 4例健康儿童和 2 6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 60ms面积与第一心音 (S1)面积之比值RTS 高于健康儿童 ,0 .0 5 >P >0 .0 1。S2 第 1谱峰峰值前后 5Hz范围内功率谱曲线所围面积 (A1)与 0～ 2 0 0Hz的功率谱曲线所围面积 (A2 )之比值RF△S低于健康儿童 ,P <0 .0 0 1。以频率响应 2 5～ 2 0 0Hz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 .0 0 1。以频率响应 0～ 10Hz低频分析 ,其RF△S值低于健康儿童 ,0 .0 5 >P >0 .0 1。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 understand the characteristics of heart sounds in children with myocarditis by three-dimensional analysis of heart sounds. Methods: Thirty-four healthy children and 26 children with myocarditis were sampled simultaneously under the same condition of heart electrocardiogram (ECG), and the acquired heart sound information was analyzed by computerized three-dimensional analysis software from the aspects of frequency, time and intensity. Results: The ratio of the 60 ms area before and after the second heart sound (S2) peak to the first heart sound (S1) area in children with myocarditis was higher than that in healthy children (P> 0.05). The ratio of the area (A2) enclosed by the power spectrum curve (A1) and the area (A2) of the power spectrum curve at 0-200Hz in the range of 5Hz before and after the peak value of S2 first peak was lower than that in healthy children, P <0. 0 0 1. The systolic murmur (SM) and diastolic murmur (DM) were analyzed by the high frequency of 25 ~ 200 Hz in frequency response, showing that the RF △ S of SM and DM in children with myocarditis was significantly higher than that of healthy children (P≤0.0001 . The frequency response of 0 ~ 10Hz low-frequency analysis, the RF △ S value was lower than healthy children, 0. 0 5> P> 0. CONCLUSIONS: The S1 intensity of children with myocarditis is significantly weakened, the low frequency component of the first peak of S2 is decreased, the SM and DM are obvious and the high frequency component is increased and the low frequency component of SM is decreased.