肥厚型心肌病与高血压伴室壁增厚患者左心室Tei指数研究  

Assessment of left ventricular Tei index in patients with hypertrophic cardiomyopathy and ventricular hypertrophy caused by hypertension

作　　者：郭亮[1] 李越[1] 

机构地区：[1]中国人民解放军总医院超声科,100853

出　　处：《中华医学超声杂志（电子版）》2010年第11期37-40,共4页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的用Tei指数评价左心室质量指数(LVMI)相近的肥厚型心肌病与高血压伴左心室壁增厚患者左心室功能。方法选取正常人35例(正常组),左心室心肌质量指数增高的高血压患者31例(高血压组),以及肥厚型心肌病患者17例(肥厚型心肌病组)。在常规超声检测基础上采用二尖瓣多普勒血流频谱(PW)、二尖瓣环组织多普勒(TVI)方法测量Tei指数。结果高血压组与肥厚型心肌病组左心室质量指数差异无统计学意义;PW和TVI所测Tei指数(TeiPW和TeiTVI)以及这两种方法测得Tei指数平均值(TeiM)均为正常组(0.38±0.015、0.46±0.07、0.45±0.11)小于高血压组(0.51±0.11、0.60±0.15、0.55±0.08)小于肥厚型心肌病组(0.61±0.10、0.71±0.23、0.63±1.73),3组之间差异有统计学意义(P<0.05);3组之间的左心室射血分数(LVEF)差异无统计学意义。在本实验所有超声心动图指标中,上述Tei指数均与室间隔厚度(IVS)和二尖瓣环组织多普勒舒张早期E峰(E’)相关性较好。多元逐步回归分析显示上述Tei指数的独立预测因子一致,为E’和IVS。结论 Tei指数对LVEF正常的肥厚型心肌病与高血压伴室壁肥厚者的左心室整体心功能早期改变具有诊断价值,肥厚型心肌病患者的心功能减低较高血压伴室壁增厚患者更明显,这两种病变心功能的早期改变以舒张功能减退为主。Objective The Tei index was applied to assess the global function of left ventricular in patients with hypertrophic cardiomyopathy and ventricular hypertrophy caused by hypertension.Methods Thirty-five healthy volunteers（group HV）,thirty-one hypertensive patients（group HP） with increased left ventricular mass index（LVMI） and seventeen patients with hypertrophic cardiomyopathy（group HCM） were enrolled in this study.Pulsed-wave（PW） and tissue velocity imaging（TVI） were used to calculate Tei index.Results There was no statistical difference of LVMI between group HP and HCM.Both of Tei indices were calculated by PW and TVI and the mean of them had the same result of group HVTei index of group as that HPTei index of group HCM（0.38±0.02 vs 0.51±0.11 vs 0.61±0.10;0.46±0.07 vs 0.60±0.15 vs 0.71±0.23;0.45±0.11 vs 0.55±0.08 vs 0.63±1.73,P0.05）,while the differences of left ventricular ejection fraction（LVEF） among the three groups were not significant.The correlations of early diastolic E velocity（E＇） at mitral annular with TVI and interventricular septal（IVS） to the above three Tei indices were all the closest in all echocardiographic parameters.Multifactor stepwise regression analysis identified E＇ and IVS as independent predictors of the above three Tei indices.Conclusion In the early clinical stage,there will be of importance on evaluation of global left ventricular function by Tei index in patients with hypertensive ventricular hypertrophy and hypertrophic cardiomyopathy,both of which have normal LVEF,and the global left ventricular function in HCM patients,primarily determined by the diastolic dysfunction with significant decrease in diastolic function.

关 键 词：多普勒超声心动描记术 肥厚型心肌病 高血压 左心室功能 

分 类 号：R542.2[医药卫生—心血管疾病]