心肌声学造影诊断高血压心肌微血管功能损害的探讨  

The Study of Myocardial Microvascular Impairment by Myocardial Contrast Echocardiography in Patients with Essential Hypertension

作　　者：迟东升[1] 王鹏[1] 靳凤霞 刘俭[1] 陈小林[1] 谢志斌[1] 李琦[1] 吴平生[1] 许顶立[1] 查道刚[1] 刘伊丽[1] 

机构地区：[1]广州第一军医大学附属南方医院心内科,510515 [2]山东省泰安市泰山慢性病医院内科,271000

出　　处：《中国医学影像学杂志》2004年第5期328-331,共4页Chinese Journal of Medical Imaging

基　　金：军队九五重点课题 (98Z0 72 ) ;十五重点课题 (0 1Z0 52 )

摘　　要：目的 :探讨心肌声学造影诊断高血压心肌微血管病变的可行性。材料和方法 :应用心肌声学造影测量 2 4例高血压病患者和 8例对照组注射潘生丁前后心肌的A值、β值和A·β值 ,并计算出A、β比值和冠脉微血管的血流储备(CMVFR)。结果 :与对照组比较 ,高血压病患者注射潘生丁后A、β和A·β值增加幅度明显降低 ,β比值以及CMVFR显著降低 ;A值与DBP、A·β值与SBP呈正相关 (r =0 .45 ,0 .3 9) ;RatioA、Ratioβ和CMVFR与SBP(r =-0 .44 ,-0 .48,-0 .5 7)、Ratioβ和CMVFR与DBP呈负相关 (r =-0 .45 ,-0 .47)。 结论 :高血压病患者心肌微血管储备功能受损 。Purpose: To investigate the myocardial microvascular impairment in patients with essential hypertension(EH) by myocardial contrast echocardiography(MCE). Materials and Methods: The values of A、β and A·β before and after dipyridamole were measured with intermittent harmonic imaging by MCE in 24 patients with EH and 8 Controls. Ratio A, ratio β and coronary microvascular flow reserve(CMVFR) were also calculated. Results: After dipyridamole, compared with controls, values of A,β,A·β,ratioβ and CMVFR in hypertensives were obviously lower. Value A correlated positively with diastolic blood pressure, and value A·βwith systolic blood pressure(r=0.45 and 0.39,respectively),whereas Ratio A, Ratioβ and CMVFR correlated inversely with systolic blood pressure (r=-0.44,-0.48 and -0.57,respectively), so did Ratio β, CMVFR with diastolic blood pressure(r=-0.45 and -0.47, respectively). Conclusion: The myocardial microvascular flow reserve is impaired in patients with EH. MCE may be helpful in diagnosing hypertensive myocardial microvascular impairment.

关 键 词：心肌声学造影 诊断 高血压 心肌微血管功能损害 并发症 潘生丁 

分 类 号：R544.1[医药卫生—心血管疾病] R542.2[医药卫生—内科学]