运动负荷门控心肌灌注显像评估高血压患者左心功能的研究  

A study on the left ventricular function of hypertension patients using exercise gated myocardial perfusion imaging

作　　者：傅宁[1] 鹿峰[1] 王亚楠[1] 吴倩[1] 鹿存芝[1] FU Ning;LU Feng;WANG Yanan;WU Qian;LU Cunzhi(Department of Nuclear Medicine, Xuzhou Central Hospital, Xuzhou, Jiangsu 221009, China)

机构地区：[1]徐州市中心医院核医学科,江苏徐州221009

出　　处：《徐州医科大学学报》2018年第4期269-273,共5页Journal of Xuzhou Medical University

摘　　要：目的 采用静息/运动负荷门控心肌灌注显像评估高血压病人左心功能，以及高血压与左心功能相关性。方法 高血压组21例，均无并发症及其他冠心病、心肌炎等疾病， LV EF〉50%,年龄55.53±17.61岁。正常血压对照组16例，年龄46.25±12.97。两组患者均行静息/运动门控心肌灌注显像，获得系列心功能指标。结果 静息状态核素心功能指标，高血压组与对照组比较，均无显著变化。运动负荷后，核素心功能指标，高血压组与对照组比较，早期充盈指标运动后PFR和△PFR（运动后/静息PFR）明显降低（2.22±0.77对3.56±0.83；0.89±0.28对1.52±0.39，P〈0.01）；收缩功能指标△ESV（运动后/静息）明显增加（0.88±0.24对0.69±0.16；P〈0.05）、△LVEF（运动后/静息）明显降低（1.02±0.12对1.10±0.07，P〈0.01）。以高血压组为研究对象，分别以△PFR、△1/3 MFR为因变量进行多元回归分析显示，性别、心肌重构，高血压疗效、高血压分级是△PFR 独立影响因素，心肌重构，高血压疗效、高血压分级是△1/3 MFR 独立影响因素 （P〈0.05）。结论 运动负荷门控心肌灌注显像是早期发现左室舒张功能障碍和收缩储备功能受损的有效方法。高血压是左室早期舒张功能障碍的独立危险因素，高血压疗效、高血压程度及其所造成的左室心肌重构是左室舒张储备功能受损的独立影像因素。Objective To assess the left ventricular function of hypertensive patients by rest/exercise gated myocardial perfusion imaging, and to assess the correlation between hypertension and left ventricular function. Methods There were 21 patients in the hypertension group, without complications, coronary artery disease, myocarditis, or other diseases, left ventricular ejection fraction （LVEF） 〉 50% and aging （55.53 ± 17.61 ） years old. There were 16 subjects in the normal blood pressure control group, aging （46.25 ±12.97） years old. All the patients underwent rest/exercise gated myocardial perfusion imaging to obtain the left ventrieular indicators. Results No statistical difference was found in the resting state left veutricular functional parameters between the two groups. After exercises, the hypertension group showed remarkable decreases in peak filling rate （PFR） , A PFR and A LVEF but marked increases in A end -systolic volume （ESV）, compared with the control （P 〈 0.05 ）. For the hypertension group, based on the multiple linear regression analysis, gender, myocardial remodeling, the treatment efficacy of hypertension and hypertension grade were the independent risk factors for △ PFR, while myocardial remodeling, the treatment efficacy of hypertension and hypertension grade were the independent risk factors for △1/3 MFR （ P 〈 0.05 ）. Conclusions Exercise gated myocardial perfusion imaging is an effective method for early response of left ventricular diastolic dysfunction and impaired contractile reserve function. Hypertension is an independent risk factor for left ventricular diastolic dysfunction. Hypertension and its left ventrieular remodeling are independent risk factors for left ventrieular diastolic function.

关 键 词：门控心肌灌注显像 高血压 左心功能 

分 类 号：R544.1[医药卫生—心血管疾病]