三平面应变率定量评价血压昼夜节律变异对高血压患者左室心肌收缩功能的影响  

Effect of ambulatory blood pressure circadian rhythm on left ventricular myocardial systolic function in hypertensive patients by tri-plane strain rate

作　　者：观志强[1] 姚怀齐[1] 王帆[1] 郑宝群[1] 陈畅[2] 郑英杰[1] Guan Zhiqiang Yao Huaiqi Wang Fan Zheng Baoqun Chen Chang Zheng Yingjie(Department of Ultrasound, the First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China Department of Cardiology, the First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China)

机构地区：[1]广东省汕头大学医学院第一附属医院超声科,515041 [2]广东省汕头大学医学院第一附属医院心内科,515041

出　　处：《中国实用医刊》2017年第19期1-5,共5页Chinese Journal of Practical Medicine

基　　金：广东省医学科研基金（B2014275）

摘　　要：目的探讨三平面（纵向、径向、周向）心内膜收缩期应变率（SRs）参数评价血压昼夜节律变异对高血压患者左室心肌收缩功能的影响。方法选取30例健康人作为对照组；63例经规律治疗及左室射血分数（LVEF）〉55%的原发性高血压（EH）患者作为研究组，根据24 h动态血压结果分为EH杓型组33例和EH非杓型组30例；超声检测并比较原发性高血压患者及对照组三平面心内膜SRs参数。结果EH杓型组和EH非杓型组24 h及白天平均收缩压和舒张压比较差异未见统计学意义（P〉0.05），EH非杓型组夜间平均收缩压和舒张压高于对照组及EH杓型组（P〈0.05），EH杓型组、EH非杓型组及对照组间LVEF水平比较差异未见统计学意义（P〉0.05）。EH非杓型组左室三平面心内膜SRs低于对照组、EH杓型组（P〈0.05）。EH杓型组的左室三平面心内膜SRs与对照组比较差异未见统计学意义（P〉0.05）。结论左室三平面心内膜SRs对评价EH患者左室心肌收缩功能有很好的临床诊断价值。Objective To figure out the preliminary clinical value of ambulatory blood pressure circadian rhythm on left ventricular myocardial systolic function in essential hypertensive patients by tri-plane （longitudinal, radial and circumferential） endoeardial systolic strain rate （SRs）. Methods Thirty healthy people were selected as control group and sixty-three essential hypertensive （EH） patients with regular treatment and preserved left ventricular ejection fraction （ LVEF 〉 55% ） were enrolled as the study group. And the essential hypertensive patients were divided into EH dippers group （n = 33 ） and EH non-dippers group （n = 30） according to the result of ambulatory blood pressure. Three groups underwent eehocardiography. All parameters were compared among the groups. Results There was no statistically significant difference in 24 hours and day-time average systolic and diastolic pressure between the EH dipper group and the EH non-dipper group （P 〉 0. 05 ）. But the night-time average systolic and diastolic pressure were higher in EH non-dipper group than those in the EH dipper group （ P 〈 0. 05 ）. All the subjects included in the present study had normal LVEF and there was no significant difference in LVEF across the three groups. Compared with other groups, the control group had significant higher E/A ratio. The parameters of tri-plane （longitudinal, radial, and circumferential） endocardial systolic strain rate all significantly reduced in the EH non-dipper group compared with the control group and the EH dipper group （ all P 〈 0. 05 ）. There was no statistically significant difference between the control group and the EH dipper group （P 〉 0. 05 ）. Conclusions Tri-plane （ longitudinal, radial, circumferential） endocardial SRs is a useful parameter for quantitatively assessing the left ventricular systolic function in EH patients. For the EH patients, it is necessary to pay early attention to the normal blood pressure circadian rhythm in addition to the cont

关 键 词：原发性高血压 血压昼夜节律变异 三平面应变率 超声心动图 左室心肌收缩功能 

分 类 号：R544.1[医药卫生—心血管疾病]