三维斑点追踪成像技术评价不同左心室构型高血压患者左心室收缩功能  

Three-dimensional speckle tracking image in evaluation on left ventricular systolic function in patients with different patterns of hypertension

作　　者：孙鹏飞[1] 王建华[1] 

机构地区：[1]中国人民解放军北京军区总医院超声科,北京100700

出　　处：《中国医学影像技术》2013年第11期1814-1818,共5页Chinese Journal of Medical Imaging Technology

基　　金：首都临床特色应用研究基金(Z121107001012143)

摘　　要：目的探讨三维斑点追踪成像(3D-STI)技术评价不同左心室构型高血压患者左心室收缩功能的价值。方法随机抽取原发性高血压患者90例和30名健康志愿者(N组),根据Ganan分类方法将原发性高血压患者分为正常构型组40例(Ⅰ组)、向心性重构组20例(Ⅱ组)、向心性肥厚组15例(Ⅲ组)及离心性肥厚组15例(Ⅳ组)。采用3D-STI技术获取左心室整体纵向收缩期峰值应变(GLS)、径向收缩期峰值应变(GRS)、圆周收缩期峰值应变(GCS)、面积收缩期峰值应变(GAS)及左心室射血分数(LVEF),并分析各组间参数的变化规律。结果 GAS随着左心室重构程度加重呈逐渐递减趋势(P<0.05),Ⅰ组GAS峰值小于N组(P<0.05);Ⅱ、Ⅲ组GLS峰值低于N、Ⅰ组(P<0.05);Ⅱ组GRS峰值高于其余各组(P<0.05);Ⅳ组GLS、GRS、GCS、GAS峰值均低于其余各组(P<0.05)。左心室GLS、GCS、GAS、GRS与LVEF相关(r=-0.42、-0.50、-0.58、0.41,P均<0.05)。结论 3D-STI技术为分析不同左心室构型高血压患者的心肌形变提供了新方法。Objective To evaluate the left ventricular systolic function of different patterns of hypertension by using three-dimensional speckle tracking imaging （3D-STI）. Methods Totally 90 hypertension patients and 30 normal subjects （group N） were enrolled. According to Ganan classification, hypertension patients were classified into normal geometry （group I , n= 40）, concentric remodeling （group II , n= 20）, concentric hypertrophy （group Ⅲ , n= 15） and eccentric hy- pertrophy （group IV, n=15）. Parameters of left ventricular systolic function, including global longitudinal peak systolic strain （GLS）, global radical strain （GRS）, global circumferential strain （GCS）, global area strain （GAS） and left ventric- ular ejection fraction （LVEF） were analyzed. Results GAS decreased with the severity of left ventricular remodeling （P〈 0.05）. Compared with group N, GAS significantly decreased in group I （P〈0.05）. GLS in group Ⅱ and Ⅲ were lower than that in group N and group I （all P〈0. 05）. GRS in groupⅡ were significantly higher than that in other groups （all P〈0.05）. Indicators of GLS, GCS, GAS, GRS in group IV were lower than those of the other groups （all P〈0.05）. In addition, GLS, GCS, GAS, GRS showed correlation with LVEF （r= --0.42, --0.50, --0.58, 0.41, all P〈0.05）. Con- clusion 3D-STI is a convenient noninvasive method for evaluation on left ventricular systolic function in patients with dif- ferent patterns of hypertension.

关 键 词：三维斑点追踪成像 心室功能 左 高血压 

分 类 号：R541.3[医药卫生—心血管疾病] R540.45[医药卫生—内科学]