应用QTVI检测高血压左心室收缩功能的临床意义  

A study on left ventricular systolic function in patients with essential hypertension using quantitative tissue velocity imaging

作　　者：刘霞[1] 王彪[1] 郄占军[1] 王琴[1] 周丽[1] 李俊仁[1] 马征[1] 贾梅[1] 王婷婷[1] 

机构地区：[1]宁夏医科大学附属医院,宁夏银川750004

出　　处：《宁夏医学杂志》2009年第9期769-771,F0002,共4页Ningxia Medical Journal

摘　　要：目的应用定量组织速度成像技术(QTVI)检测临床无心衰症状的高血压患者是否存在左心室收缩功能的受损。方法选择左室射血分数正常的高血压病患者98例作为病例组,其中无心衰症状且无左室肥厚者39例(I组),无心衰症状有左室肥厚者43例(II组),伴有心衰症状者16例(III组);39例健康查体者为正常对照组。以QTVI测量二尖瓣环收缩期速度峰值(Sa)、舒张早期速度峰值(Ea)及舒张晚期速度峰值(Aa)。结果II组和III组的平均Sa低于正常对照组和I组,差异有统计学意义;III组的平均Sa低于II组,差异有统计学意义。平均Ea以正常对照组、I组、II组、III组的顺序逐渐减低,各组间的差异有统计学意义。多元回归分析显示,平均Ea、平均Aa和女性是平均Sa的独立预测因素。结论高血压病人在出现左室肥厚时,即使无心衰临床表现,其左室长轴收缩功能也受了损害;QTVI检测的二尖瓣环运动速度在判断左室收缩和舒张功能方面有重要临床价值。Objective To explore the change of systolic long- axis left ventricular function in asymptomatic hypertensive patients. Methods 98 essential hypertensive patients with no heart failure were divided into three groups, group I, 39 without left ventricular hypertrophy; group II, 43 with left ventricular hypertrophy; group III, 16 essential hypertensive patients with diastolic heart failure. And thirty - nine healthy subjects were randomly selected. No significant differences between groups in LV ejection fraction were noted. QTVI -derived peak velocity （Sa, Ea and Aa） was measured at mitnal annulus （septal and lateral）, and mean peak velocity was calculated by averaging data. Results Mean Sa levels in the group II and group III were significantly lower than that in healthy subjects and group I. Mean Sa levels in the group II was significantly lower than that in the group III. Comparing with that in group I, group II and group III, the mean Ea levels decreased progressively from the normal control subjects. Using muhivariable linear regression analysis, mean Ea （ P 〈 0.0001 ）, mean Aa （P 〈 0. 0001 ）, and female gender（ P 〈 0. 005 ） were found to be independent predictors of Sa. Conclusion Systolic long - axis LV function is impaired in hypertensive patients without symptom and/or syndrome of heart failure. The systolic and diastolic LV function of hypertensive patients are correlaled and interactive. The assessment of LV longitudinal function by QTVI plays an important role in identifying not only diastolic dysfunction, but also sub clinical LV systolic dysfunction.

关 键 词：定量组织速度成像技术 二尖瓣环 左心室 功能 高血压 

分 类 号：R544.1[医药卫生—心血管疾病]