组织多普勒技术评价原发性高血压患者左心室功能的临床研究  

Study on Left Ventricular Systolic and Diastolic Function by the Tissue Doppler Imaging in Essential Hypertensive Patients

作　　者：高磊[1] 黄灿亮[2] 高铁麟[2] 周贵明[2] 张希玲[2] 马萍[2] 

机构地区：[1]天津市第三中心医院,300170 [2]天津医科大学总医院

出　　处：《天津医药》2009年第5期359-361,共3页Tianjin Medical Journal

摘　　要：目的:评价组织多普勒(TDI)技术中Tei指数及二尖瓣环收缩期运动速度(Sa)测定原发性高血压病不同左室构型患者左室功能的价值。方法:原发性高血压患者80例,分为非肥厚组(Ⅰ组)、肥厚组(Ⅱ组),各40例,对照组40例。用PW技术测量室间隔(IVSd)、左心室后壁厚度(LVPWd)及左心室舒张末内径(LVDd),并记录左心室射血分数(LVEF)、二尖瓣血流频谱图舒张早期与舒张晚期血流峰值比(E/A)。TDI技术于二尖瓣环选取室间隔、左心室侧壁、前壁和下壁4个位点,测量各位点Tei指数、二尖瓣环处收缩期运动速度Sa值(Sa为二尖瓣环收缩期运动速度)并取平均值(Sm)及舒张早期与舒张晚期峰速比(Ea/Aa)。结果:(1)3组IVSd、LVPWd、RWT差异有统计学意义(P<0.01),E/A与Ea/Aa在对照组均>1,在Ⅰ组、Ⅱ组均<1,Ⅰ组、Ⅱ组均低于对照组(P<0.01),Ⅰ组、Ⅱ组差异无统计学意义(P>0.05);3组LVEF差异无统计学意义(P>0.05)。(2)3组Tei指数、IVCT呈递增趋势,Sm值呈递减趋势,差异有统计学意义(P<0.01)。结论:(1)Sm值作为一个独立的TDI指标较LVEF更能早期、敏感地评价左心室收缩功能。(2)Tei指数能简便、敏感、综合评价高血压病患者左心室的舒缩功能,具有不易受其他因素干扰、重复性好等特点。Objective： To study the clinical value of the Tei index and the systolic mitral annular velocities （Sa） of the tissue doppler imaging（TDI） in assessing the left ventricular systolic and diastolic function of the patients with essential hypertension. Methods： Eighty patients with essential hypertension were enrolled in this study. The patients were divided into two groups, 40 patients with no left ventricular hypertrophy（group Ⅰ ） and 40 with left ventricular hypertrophy（group Ⅱ ）. Forty normal individuals were enrolled as the control group. The interventricular septal defect （IVSd）, left ventricle posterior wall depth （LVPWd）, left ventricle end diastolic inside diameter （LVDd）, left ventricle ejection fraction （LVEF） and the E/A ratio were measured by the method of PW. The doppler sample volumes were placed at the septum, lateral, anterior, and inferior sites. The Ea/Aa ratio, Sa, Sm, and the Tel indexes were measured by the TDI echocardiography. Results： There were significant differences in IVSd, LYPWd and RWT in three groups（P 〈 0.01）. The values of E/A ratio and Ea/Aa ratio were lower in group Ⅰ and Ⅱ than those in control group（P 〈 0.01）. The values of E/A ratio and Ea/Aa ratio were 〉 1 in control group, and were 〈 1 in group Ⅰ and group Ⅱ. There was no significant difference in LVEF between three groups （P 〉 0.05）. The values of Tei index and IVCT were gradually increased between three groups （P 〈 0.01）. The value of Sm were gradually decreased between three groups （P 〈 0.01）. Conclusion： The value of Sm is an earlier, more sensitive and accurate indicator of TDI in reflecting the left ventricular systolic function. The value of Tei index is more convenient and sensitive for evaluating the global function of the left ventricle.

关 键 词：超声心动描记术 多普勒 二尖瓣 高血压 心室功能 左 心缩期 

分 类 号：R544.1[医药卫生—心血管疾病] R540.45[医药卫生—内科学]