原发性高血压患者左室收缩同步性与Tpe间期关系的初步研究  

Relationship of left ventricular systolic synchrony to Tpe interval in essential hypertension

作　　者：王德超[1] 王爱玲[1] 汪太平[1] 史学功[1] 金朝龙[1] 肖洁[1] 许昌庆[1] 

机构地区：[1]安徽医科大学第一附属医院心血管内科,合肥230022

出　　处：《安徽医科大学学报》2016年第7期1019-1022,共4页Acta Universitatis Medicinalis Anhui

基　　金：安徽高校自然科学研究项目(编号:KJ2015ZD24)

摘　　要：目的研究原发性高血压患者的左室收缩同步性与Tpe间期的关系。方法选取原发性高血压患者196例(正常构型组44例、向心型重构组45例、向心型肥厚组58例、离心型肥厚组49例)和健康体检者40例(正常对照组)。采用实时三维超声心动图(RT-3DE)获得左心室收缩同步性相关参数:左心室16节段经心率校正后达到收缩末期最小容积时间的标准差(Tmsv16-SD%,即SDI)以及最大时间差(Tmsv16-Dif%,即DIF)。根据心电图获得Tpe间期、校正Tpe间期(Tpec)。比较各组间差异并分析SDI、DIF分别与Tpe间期、Tpec之间的相关性。结果与正常对照组比较,正常构型组SDI、DIF增大(P<0.05),Tpe间期及Tpec差异无统计学意义;向心型重构组除Tpec外,其余参数均增大(P<0.05);向心型肥厚组及离心型肥厚组各参数均增大(P<0.05)。与正常构型组比较,向心型重构组各参数差异无统计学意义,向心型肥厚组及离心型肥厚组各参数均增大(P<0.05)。与向心型重构组比较,向心型肥厚组及离心型肥厚组各参数均增大(P<0.05)。与向心型肥厚组比较,离心型肥厚组各参数均增大(P<0.05)。SDI、DIF分别与Tpe间期及Tpec呈正相关性(r=0.56、0.50,0.44、0.52,P<0.01)。结论在原发性高血压患者中,随着重构加重,左室收缩不同步性与Tpe间期逐渐增加,左室收缩不同步性与Tpe间期呈正相关性。Objective To evaluate the relationship of left ventricular systolic synchrony to Tpe interval in essential hypertension. Methods 40 healthy persons and 196 patients with essential hypertension were chosen,including 44 cases of normal geometry,45 cases of concentric remodeling,58 cases of concentric hypertrophy and 49 cases of eccentric hypertrophy. Parameters about left ventricular systolic synchrony were acquired by RT-3DE,including the standard deviation（ systolic dyssynchrony index,SDI） and the maximum difference（ Tmsv16-Dif%,DIF） of left ventricular 16 segment systolic volume peak time respectively. Tpe interval and corrected Tpe（ Tpec） interval were acquired by ECG. All parameters were compared between groups. The correlation between left ventricular systolic synchrony parameters and Tpe interval and the correlation between left ventricular systolic synchrony parameters and Tpec were analyzed. Results Compared with normal control group,SDI and DIF of normal geometry group were increased（ P 〈0. 05）,but there was no significant difference in Tpe interval and Tpec between the normal control group and the normal geometry group. All parameters except Tpec in concentric remodeling group were higher than those in the normal control group（ P〈 0. 05）. All parameters in concentric hypertrophy group and eccentric hypertrophy group were higher than those in the normal control group（ P〈 0. 05）. The differences of all parameters between the normal geometry group and concentric remodeling group were not significant. Compared with the normal geometry group,all parameters were increased in concentric hypertrophy group and eccentric hypertrophy group（ P 〈0. 05）. Compared with concentric remodeling group,all parameters were increased in concentric hypertrophy group and eccentric hypertrophy group（ P〈 0. 05）. Compared with concentric hypertrophy group,all parameters were increased in eccentric hypertrophy group（ P 〈0. 05）. SDI and DIF had positive correlation with Tpe interval and

关 键 词：超声心动描记术 实时三维 原发性高血压 左室重构 同步性 Tpe间期 

分 类 号：R544.1[医药卫生—心血管疾病] R540.45[医药卫生—内科学]