脉冲组织多普勒技术对正常人及高血压病患者心功能的评价  

Pulsed tissue Doppler imaging in the evaluation of heart function in patients with hypertension and healthy subjects

作　　者：宋嫣[1] 钟小亮[1] 

机构地区：[1]南昌市第一医院超声科,南昌330000

出　　处：《放射学实践》2012年第10期1135-1138,共4页Radiologic Practice

摘　　要：目的:探讨脉冲组织多普勒成像(PW-TDI)技术评价正常人及原发性高血压病患者左室功能的价值。方法:选取原发性高血压患者43例,其中左室心肌肥厚者22例,非肥厚者21例,采取65例作为正常对照组,获取标准心尖位左心长轴切面、二腔切面和四腔面,分别应用组织多普勒成像(TDI)于左室后间隔、侧壁、右室游离壁、前壁、下壁、前间隔及后壁的瓣环处,测量7个位点的心肌运动峰值速度Vs、Ve、Va,并计算Ve/Va值,用常规脉冲多普勒超声测得二尖瓣口舒张期前向血流E峰、A峰并计算E/A值。结果:高血压患者后间隔、前间隔、后壁、前壁、下壁的收缩峰值速度与正常对照组相比均明显下降(P<0.05)。高血压患者后间隔、前间隔、前壁、下壁的舒张早期峰值速度与正常对照组后相比明显降低(P<0.05)。高血压患者舒张功能E/A比值及后间隔、前间隔、后壁、前壁、下壁的Ve/Va比值与正常对照组相比明显减低(P<0.05)。不同的位点心肌收缩幅度与舒张幅度不同(P<0.05)。结论:正常对照组瓣环不同部位的收缩期峰值速度及Ve/Va比值不一致。与正常人相比,高血压病患者瓣环处不同部位收缩期峰值速度及Ve/Va比值减低,但在不同部位减低程度不一致,提示心脏室壁不同部位对高血压的反应不一致,其机理有待进一步研究。Objective:To explore the value of pulse wave tissue Doppler imaging(PW-TDI) for the evaluation of left ventricular function of healthy subjects and essential hypertension patients.Methods:43 patients with essential hypertension including 22 patients with left ventricle myocardium hypertrophy and 21 patients without hypertrophy were selected.65 normal subjects were randomly enrolled as control group.TDI with standard long-axis view,2-chamber view and 4-chamber view of left ventricle was used to measure the myocardial motion peak velocity Vs,Ve,Va at 7 points including valve annulus of left ventricular posterior septum,lateral wall,right ventricular free wall,anterior wall,inferior wall,anterior septum and posterior wall and the Ve/Va ratios of them were calculated.Diastolic peak E,peak A on mitral valve with conventional pulsed Doppler ultrasonography were measured and the E/A value was calculated.Results:The systolic peak velocity at posterior septum、anterior septum、posterior wall、anterior wall、inferior wall of hypertensive patients were significantly lower than that of the controls(P<0.05) as well as the early diastolic peak velocity at posterior septum、anterior septum、posterior wall、anterior wall、inferior wall(P<0.05).The diastolic E/A ratio and the Ve/Va ratio at posterior septum、anterior septum、posterior wall、anterior wall、inferior wall of hypertensive patients were significantly lower than that of the controls(P<0.05).The systolic and diastolic amplitude of myocardium at different sites varied(P<0.05).Conclusion:Measured by pulsed tissue Doppler imaging,the peak systolic velocity and Ve/Va ratio in different parts of the valve annulus varied.Compared with normal subjects,the peak systolic velocity and Ve/Va ratio reduced in various parts of the valve annulus in hypertensive patients,but inconsistent in different parts,which suggested that the reaction of different parts of the heart wall is inconsistent with hypertension,the mechanism should be further studied.

关 键 词：超声检查 多普勒 高血压 心室功能 左 

分 类 号：R445.1[医药卫生—影像医学与核医学] R544.1[医药卫生—诊断学]