伴和不伴左室肥厚高血压患者的组织多普勒特征及其在心功能评价中的价值  

The characteristics and significance of Doppler tissue imaging in hypertensive patients with or without left ventricular hypertrophy

作　　者：杨帆[1] 宾建平[1] 农盛雄[2] 陈少敏[1] 李崇信[1] 王鹏[1] 

机构地区：[1]南方医科大学南方医院心内科,广州市510515 [2]广东省惠州市中心医院心内科,516001

出　　处：《实用医学杂志》2008年第5期731-733,共3页The Journal of Practical Medicine

基　　金：国家“863”计划基金资助项目(编号:2006AA02Z478)

摘　　要：目的:应用组织多普勒(DTI)观察伴有和不伴有左室肥厚的高血压患者的组织多普勒特征,探讨DTI在心功能评价中的价值。方法:入选30例高血压患者,分为左室肥厚组(LVH组,15例)与非左室肥厚组(non-LVH组,15例),另选取15例健康人作为对照组,分别行超声多普勒及DTI检查,多普勒超声测量室间隔厚度(IVSd)、左心室后壁厚度(LVPWd)、左心房厚度(LAD),DTI模式测量二尖瓣瓣环心肌收缩峰值速度(Vs)、舒张早期运动速度(Ve)、舒张晚期运动速度(Va)和Ve/Va,以及用猪尾导管直接测量左室舒张末压(LVEDP)。结果:与对照组相比,LVH组和non-LVH组的Ve和Ve/Va显著减小,且LVH组比non-LVH组减小更明显(P<0.05);non-LVH组的Va与对照组相比无明显改变(P>0.05),但LVH组的Va较对照组及non-LVH组显著增大(P<0.05)。Ve/Va与LVPWd及LVEDP呈良好的线性相关。结论:伴有和不伴有左室肥厚的高血压患者均有舒张功能降低,且与左室厚度呈正相关;DTI是评价左室舒张功能的可靠方法。Objective To observe the characteristics and significance of Doppler tissue imaging （DTI）in hypertensive patients with or without left ventricular hypertrophy （LVH）, and to explore the value of DTI in evaluating cardiac function. Methods 30 hypertensive patients who were divided into LVH group （n=15） and non-LVH group （n= 15） and 15 controls were measured by ultrasonic Doppler and DTI. Interventricular septal thickness （IVSd）, left ventricular posterior wall thickness （LVPWd）, and left atrial thickness （LAD）were measured by ultrasonic Doppler, while myocardial systolic peak velocity （Vs）, early diastolic velocity （Ve）,late diastolic velocity （Va）, and Ve/Va in mitral ring were measured by DTI and left ventricular end diastolic pressure （LVEDP） by a fluid-filled catheter. Results As compared with those in the control group, Ve and Ve/Va in the LVH group and non-LVH group decreased significantly and more evidently in the LVH group （P 〈 0.05 ）. Va was markedly elevated in the LVH group as compared to the control group and non-LVH group （P 〈 0.05 ） and did not differ significantly between the latter two groups （P 〉 0.05 ）. There was a good linear relationship between Ve/Va and LVPWd or LVEDP. Conclusions Hypertensive patients, with or without LVH, all have diastolic dysfunction which is positively related to LVPWd. DTI is a reliable procedure for evaluating left ventricular diastolic function.

关 键 词：高血压 超声检查 多普勒 肥大 左心室 超声心动图 

分 类 号：R544.1[医药卫生—心血管疾病]