Tei指数评价不同脉压的老年高血压患者左室功能的研究  

Evaluation on left ventricular function in elderly hypertensive patients with different pulse pressure by Tei index

作　　者：郭清[1] 关浩增[1] 莫永秀[1] 杨珈玲[1] 

机构地区：[1]广西壮族自治区江滨医院,南宁530021

出　　处：《广西医学》2005年第11期1723-1726,共4页Guangxi Medical Journal

摘　　要：目的探讨应用Tei指数评价不同脉压的老年高血压患者左室功能的临床研究。方法对62例老年高血压患者及24例血压正常老年人对照者进行24h动态平均脉压(24hMPP)测定,按24hMPP不同将高血压病患者分为24hMPP<60mmHg组(Ⅰ组,32例)和24hMPP≥60mmHg组(Ⅱ组,30例)。所有观察对象用常规超声心动图测量左室舒张末期室间隔、左室后壁厚度及左室内径(IVS、LVPW、LVDEd)。计算左室心肌重量指数(LVMI)、二尖瓣血流频谱图舒张早期与舒张晚期峰值比(EA)、左室等容舒张时间(IVRT)、主动脉射血时间(ET)、左室射血分数(EF)以及Tei指数。结果Ⅱ组LVEDd与Ⅰ组和对照组比较增大(P<0.05)。Ⅰ、Ⅱ组IVS、LVPW、LVMI与对照组比较增加(P<0.05)。Ⅰ、Ⅱ组EA与对照组比较减小(P<0.05),Ⅱ组减小更为明显(P<0.05)。Ⅰ、Ⅱ组的IVRT、Tei指数较对照组延长(P<0.05),且Ⅱ组的延长幅度比Ⅰ组大。脉压与IVRT、Tei指数正相关(r=0.48,r=0.47,P<0.05),与EF、EA轻度负相关(r=-0.32,-0.36,P<0.05)。结论脉压增大影响老年高血压患者的左心室功能。Tei指数能直观、简便、敏感、综合评价老年高血压患者左心室的整体功能。Objective To evaluate the left ventrieular function in elderly hypertensive patients with different pulse pressure by Tei in- dex.Methods 62 hypertensive patients and 24 normotensive controls （ age ≥ 60 years） were measured of ambulatory blood pressure monitoring. According to 24 hours ambulatory pulse pressure（24 h MPP）,62 hypertensive patients were divided into two groups：group Ⅰ （32 cases,24 h MPP 〈60 mmHg）,and group Ⅱ （30 cases,24 h MPP≥60 mmHg）.All patients were measured the diastolic diameters of left ventricle（LVDEd） ,the thickness of interventricular septum（IVS） and left ventficular posterior wall（LVPW） by echocardiograph,then left ventricular mass index（LVMI） was calculated. And, E/A ratio（E/A） at mitral orifice, isovolumic relaxation fime（IVRT）, aortic ejection time（ET）,left ventricacular ejection fraction（ EF） and Tei index were measured. Results The LVDED in group Ⅱ was larger than those of group Ⅰ and controls （ P 〈 0.05） .The IVS,LVPW and LVMI in group Ⅰ and Ⅱ were significantly increased compared with those of controls（ P 〈0.05）.E/A in group Ⅰ and Ⅱ was significantly decreased compared with that of the controls,and group Ⅱ was the least.The IVRT and Tei index were more prolonged than those of controls,but in group Ⅱ was longer,than that of group Ⅰ （ P 〈 0.05） .24 h MPP was positively correlated with IVRT and Tei index （r =0.48,0.47,respectively. P〈0.05）;but negatively with EF and E/A（r = -0.32, - 0.36. P 〈 0.05）.Conclusions Increasing pulse pressure may affect the left ventrieular function in elderly hypertensive patients. Tei index is valuable and simple for evaluatiing left ventricular systolic and diastolic functions with high sensitivity.

关 键 词：TEI指数 高血压 左室功能 脉压 老年人 

分 类 号：R544.1[医药卫生—心血管疾病]