高血压患者心房内与心房间不同步性组织多普勒评价及其影响因素  

Assessment of Intratrial and Interatrial Synchronicity and Its Influencing Factors in Patients with Hypertension by Tissue Doppler Imaging

作　　者：邓燕[1] 郭盛兰[1] 

机构地区：[1]广西医科大学第一附属医院超声科,南宁市530021

出　　处：《广西医学》2012年第2期141-144,共4页Guangxi Medical Journal

基　　金：广西自然科学基金(2010GXNSFA013138);广西医疗卫生科研课题(桂卫Z2011363)

摘　　要：目的探讨组织多普勒评价高血压患者心房内和心房间不同步性价值及其影响因素。方法测量40例健康体检者和40例高血压患者P波起始点至心尖四腔观二尖瓣前瓣、后瓣及三尖瓣前瓣组织多普勒曲线上A波起始点的时限,即心房电机械时间(P-LA、P-IAS、P-RA),计算左房内、右房内及左右心房间不同步性(T1、T2、T3),即PL-LA与P-IAS、P-IAS与P-RA、P-LA与P-RA差值;分析高血压患者组织多普勒指标与左室心肌质量指数(LVMI)、左房内径(LAD)等参数的相关关系。结果高血压组LVMI、LAD明显大于对照组(P<0.05)。高血压组P-LA、P-IAS较对照组明显延长(P<0.05),T1、T2、T3较对照组明显增大(P<0.05)。P-LA、P-IAS及T1、T3与LVMI、LAD均呈明显正相关关系(P<0.05)。结论组织多普勒可准确评价高血压患者心房内和心房间不同步性,高血压患者左室心肌重量增加重塑导致左房增大,可能是引起左房内和心房间不同步的重要原因。Objective To investigate the value of tissue Doppler imaging（TDI） in the assessment of intratrial and interatrial synchronicity in patients with hypertension and its influencing factors. Methods Artial electromechanical time of 40 healthy volunteers and 40 patients with hypertension was detected by TDI, which was the interval from the initiation of P wave on the electrocardiogram（ECG） to the onset of A wave at the late the anterior mitral valve annulus （PIAS） ,lateral mitral valve annulus（PLA） and anterior tricuspid valve annulus（PRA） derived from TDI. Intratrial synchronicity was defined as the differences between P-LA and P-IAS （ T_1 ） , PIAS and PRA （ T_2 ）, while interatrial synchronicity defined as the difference between P-LA and P-RA （T_3 ）. T_1, T_2 and T3 were calculated. The correlations between TDI indices of patients with hypertension and indices including left ventricular mass index （LVMI） and left atrial diameter（LAD） were analyzed. Results LVMI and LAD were higher in patients with hypertension than in controls （P 〈0.05）. PLA,PIAS were significantly longer and T_1 ,T_2 ,T_3 were significantly higher in patients with hypertension than in controls （ all P 〈 0.05 ）. PLA, PIAS and T_1, T_3 correlated positively with LVMI and LAD （ P 〈 0.05 ）. Conclusion Intratrial and interatrial synchronicity in patients with hypertension can be accurately assessed by TDI. Left atrial increasing caused by left ventricular remodeling may be the important factor of left atrial intratrial and interatrial synchronicity in patients with hypertension.

关 键 词：超声心动图描记术 组织多普勒成像 高血压 心房 电机械耦联 

分 类 号：R544.1[医药卫生—心血管疾病]