多普勒超声在评价高血压患者左心室舒张功能中效果的系统评价  

Effectiveness of doppler ultrasound in assessment of left ventricular diastolic function in hypertension patients

作　　者：关秀萍[1] 黎明丽[1] 杨柳[1] 

机构地区：[1]武汉大学医院内科,武汉430072

出　　处：《中国循证心血管医学杂志》2010年第4期219-227,共9页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：中央高校基本科研业务费专项资金支持(634275090)

摘　　要：目的系统评价多普勒超声(DUS)在高血压患者左心室舒张功能中的价值。方法计算机检索Cochrane图书馆(2010年第1期)、MEDLINE、EMbase、CBMdisc、VIP、CNKI和WANFANG DATA,并手工检索相关的中文杂志,查找有关应用多普勒超声评价高血压左心室舒张功能的临床对照研究(检索年限均为建库至今)。由3名评价者独立对纳入临床研究进行质量评价和提取资料后,采用RevMan5.0.0软件对资料进行Meta分析。结果最终纳入13个研究,共1170例受试者。结果显示,在高血压的不同时期,相关指标的敏感性有所差异。高血压组的二尖瓣口舒张早期血流峰值流速(E峰),E/A值均低于正常组,其结果有统计学意义(SMD=-1.43;95%CI:-1.96～-0.89),(SMD=-2.13;95%CI:-3.04～-1.23);高血压组的舒张晚期血流峰值流速(A峰),左心室舒张末内径,左室心肌重量指数,左房内径均高于正常组,其结果有统计学意义(SMD=1.47;95%CI:0.95～1.99),(SMD=4.06;95%CI:1.78～6.34),(SMD=7.34;95%CI:4.59～10.09),(SMD=2.75;95%CI:1.48～4.03);高血压组的减速时间略高于正常组,但其结果无统计学意义(SMD=0.50;95%CI:-0.11～1.12)。结论本系统评价结果显示,DUS在评价高血压患者左室舒张功能障碍有一定的价值,且可为临床分期提供参考,是一种有效的辅助手段。但应注意超声指标的应用条件,注意各个参数的适用范围及局限性。Objective To review systemically the values of doppler ultrasound （DUS） in assessment of left ventricular diastolic function in hypertension patients.Methods The data of DUS in assessment of left ventricular diastolic function in hypertension patients were retrieved with computer from Cochrane Library （the first issue of 2010）,MEDLINE,EMbase,CBMdisc,VIP,CNKI and WANFANG DATA,and clinical controlled trials were searched from Chinese language magazines munually （the time limit for retrieval was from database establishment up to now）.After 3 reviewers appraised the quality and extracted the data independently,the data were given Meta analysis by using software RevMan 5.0.0.Results Finally there were 1170 objects were included into 13 studies.The results showed that the sensitivity of relevant indexe was different in different hypertension periods.In the hypertension group,E value of early diastolic peak velocity of mitral orifice and E/A value were lower than those in the normal group and the outcomes had statistical significance（SMD=-1.43;95%CI：-1.96^-0.89）,（SMD=-2.13;95%CI：-3.04^-1.23）.In the hypertension group A value of late diastolic peak velocity,LVDd,LVMI and LAD were higher than those in the normal group and the outcomes had statistical significance（SMD=1.47;95%CI：0.95~1.99）,（SMD=4.06;95%CI：1.78~6.34）,（SMD=7.34;95%CI：4.59~10.09）,（SMD=2.75;95%CI：1.48~4.03）.The deceleration time （DT） of the hypertension group was higher a little than that of the normal group,but the outcome had no statistical significance（SMD=0.50;95%CI：-0.11~1.12）.Conclusion The results of this systematic review showed that DUS was valuable for assess left ventricular diastolic dysfunction in hypertension patients.It can be an effective aid and provides the reference for clinical stages of hypertension.The application conditions of DUS and the applicability and limitations of all parameters should be paid attention to.

关 键 词：多普勒超声 评价 高血压 左心室舒张功能 META分析 系统评价 

分 类 号：R540.45[医药卫生—心血管疾病]