彩色多普勒超声对高血压左心室向心性与离心性心肌肥厚患者左心室舒张功能的评价  

Evaluation of left ventricular diastolic function between concentric and eccentric left ventricular hypertrophy in hypertensive patients using Doppler echocardiography

作　　者：刘爱玲[1] 王志斌[1] 孟媛媛[1] 宫坤[1] 

机构地区：[1]青岛大学附属医院心脏超声科,山东青岛266003

出　　处：《中国中西医结合影像学杂志》2017年第3期305-307,共3页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：青岛市市南区科技发展计划项目(2014-14-029-YY)

摘　　要：目的:探讨应用多普勒超声评估高血压左心室向心性与离心性肥厚患者左心室舒张功能障碍的差异,为评价左心室舒张功能受损程度提供依据。方法:选择原发性高血压患者246例,根据左心室构型分为正常构型组、向心性重构组、离心性肥厚组、向心性肥厚组。左心室舒张功能的评估应用脉冲多普勒测量二尖瓣舒张早期血流峰值(E)及舒张晚期血流峰值(A),计算E/A值;组织多普勒测量二尖瓣环舒张早期运动峰值速度(Em),计算E/Em值。结果:与正常构型组相比,室间隔厚度及左心室厚壁厚度在向心性重构组、离心性肥厚组及向心性肥厚组均显著增加(均P<0.01)。与正常构型组相比,左心室舒张末期内径在向心性重构组明显减小,在离心性肥厚组明显增大(均P<0.01)。左心房内径在离心性肥厚组和向心性肥厚组比正常构型组和向心性重构组显著增加(P<0.01),在离心性肥厚组和向心性肥厚组之间比较差异无统计学意义(P>0.05),向心性重构组比正常构型组减小(P<0.05)。与正常构型组比较,反映左心室舒张功能的参数E/A和Em在离心性肥厚组和向心性肥厚组均显著降低(均P<0.01);E/Em在向心性肥厚组比离心性肥厚组显著增高(P<0.01)。结论:在高血压左心室肥厚患者中,向心性肥厚患者的左心室舒张功能障碍比离心性肥厚患者严重。Objective：To explore the differences of left ventricular （LV） diastolic dysfunction between eccentric and concentric left ventricular hypertrophy （LVH） in hypertensive patients using Doppler Echoeardiography, so as to provide the basis for LV diastolic function damage evaluation. Methods：A total of 246 patients with essential hypertension were selected and divided them into four groups. LV diastolic function was assessed by measurements of peak early transmitral flow velocity （E）/peak late transmitral flow velocity （A） by adopting PW-Doppler （the FJA ratio）,peak early diastolic mitral annular velocity （Em） by adopting tissue Doppler and the E/Em ratio. Results：Compared with the normal LV geometry group,the eccentric and concentric LVH groups had significantly lower values for two parameters reflecting LV diastolic function （E/A,P〈0.01;Em,P〈0.01）. E/Em was significandy higher in the concentric LVH group compared with the eccentric LVH group （P〈0.01）. Conclusion：Among hypertensive patients with LVH,those with concentric LVH have more severe LV diastolic dysfunction than those with eccentric LVH.

关 键 词：高血压 心室重构 左室舒张功能 超声心动描记术 多普勒 彩色 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541.3[医药卫生—诊断学]