组织多普勒评估年龄及性别对左心室舒张功能及左心室充盈压的影响  

Tissue Doppler imaging observation of impact on aging and gender on left ventricular diastolic function and left ventricular filling pressure

作　　者：陈宝霞[1] 李雪梅 王方芳[1] 徐明[1] 李昭屏[1] 冯新恒[1] 

机构地区：[1]北京大学第三医院心内科,北京100191 [2]北京市中关村医院超声室,北京100190

出　　处：《中国医学影像技术》2010年第12期2281-2284,共4页Chinese Journal of Medical Imaging Technology

基　　金：国家高技术研究发展计划(2007AA02Z457)

摘　　要：目的应用脉冲多普勒及组织多普勒成像评价年龄及性别对健康人左心室舒张功能及左心室充盈压的影响。方法健康体检人员共213名,按年龄分为6组(20～29、30～39、40～49、50～59、60～69和70～87岁组),测量二尖瓣舒张早期血流峰值速度(E)、舒张晚期血流峰值速度(A)、二尖瓣环侧壁舒张早期运动速度(Em),计算E/A、E/Em。分析年龄、性别与以上各参数的相关性。结果年龄与E、E/A呈负相关(r=-0.53、-0.70,P<0.01),与A呈正相关(r=0.58,P<0.01),与Em呈负相关(r=-0.75,P<0.01),与E/Em呈正相关(r=0.41,P<0.01)。随着年龄的增长,E、E/A逐渐降低,A逐渐升高,在50岁后出现E/A<1,Em逐渐降低,E/Em逐渐增高,70岁后E/Em明显增高。男性E/Em值(6.04±1.05)与女性E/Em值(6.57±1.87)比较差异有统计学意义(P<0.05),且70～87岁组女性E/Em高于男性(P<0.01)。结论 E、A、E/A、Em及E/Em与增龄关系密切,组织多普勒指标更敏感,E/Em值在70～87岁组中女性高于男性,70～87岁组女性较男性舒张功能指标减低更显著,应用二尖瓣血流频谱及组织多普勒评价左心室舒张功能及左心室充盈压时应充分考虑年龄及性别的影响,应根据不同年龄段及性别给出相应的参考数值。Objective To evaluate the impact of aging and gender on left ventricular diastolic function and left ventricular filling pressure （LVFP） with tissue Doppler imaging （TDI）. Methods Totally 213 healthy subjects were divided into 6 groups （aged 20—29,30—39,40—49,50—59,60—69 and 70—87 years）. Mitral peak early diastolic transmitral flow velocity （E）,mitral peak late diastolic transmitral flow velocity （A）,E/A ratio were measured with pulse-wave Doppler. Peak early mitral annular velocity （Em）,E/Em ratios were measured with TDI of lateral mitral annulus. Correlation of each parameter with age and gender was analyzed. Results E and E/A correlated negatively with age （r=-0.53,-0.70,all P0.01）. A correlated positively with age （r=0.58,P0.01）,Em correlated negatively with age （r=-0.75,P0.01）,E/Em ratio correlated positively with age （r=0.41,P0.01）. With aging,mitral E,E/A ratio statistically decreased,A increased,E/A ratio 1 emerged in subjects larger than 50 years. Em statistically decreased with aging,but E/Em ratio increased,especially in subjects larger than 70 years. Comparing male and famale of all ages,the mean E/Em for male was 6.04±1.05,6.57±1.87 for female （P0.05）. Comparison between male and famale in each age group,among those aged 70 or older,E/Em ratio of lateral annulus was significantly higher in females than that in males （P0.01）. Conclusion E,A,E/A ratio,Em and E/Em ratio are closely related with aging,and TDI is sensitive in evaluating of these indexes. In the elder population,diastolic function E/Em ratio deteriorates more significantly in the female than in the male. When left ventricular diastolic function and LVFP are evaluated with mitral pulse-wave Doppler and TDI in the elder subjects,the impact of aging and gender should be considered. Different reference value should be provided according to different age and gender.

关 键 词：超声心动描记术 心舒期 心室功能 左 年龄因素 性别因素 

分 类 号：R331[医药卫生—人体生理学] R540.45[医药卫生—基础医学]