组织多普勒成像联合Tei指数对原发性醛固酮增多症患者左心室舒张功能评估的相关性研究  

Correlation Between Tissue Doppler Imaging and Tei Index in Evaluating Left Ventricular Diastolic Function in Patients with Primary Aldosteronism

作　　者：吴仰帆[1] 赖玉琼[1] 王晓洲[2] 蓝宁辉 WU Yangfan;LAI Yuqiong;WANG Xiaozhou;LAN Ninghui(Department of Cardiac Function Examination,The First People's Hospital of Foshan City,Foshan 528000,Guangdong,China;Endocrine Department of The First People's Hospital of Foshan,Foshan 528000,Guangdong,China;Ultrasonic Diagnosis and Treatment Center of Foshan First People's Hospital,Foshan 528000,Guangdong,China)

机构地区：[1]佛山市第一人民医院心脏功能检查科,广东佛山528000 [2]佛山市第一人民医院内分泌内科,广东佛山528000 [3]佛山市第一人民医院超声诊疗中心,广东佛山528000

出　　处：《心血管病学进展》2020年第2期214-218,共5页Advances in Cardiovascular Diseases

基　　金：佛山市卫生健康局医学科研基金项目(20170020)。

摘　　要：目的探讨组织多普勒成像参数改变联合Tei指数与原发性醛固酮增多症(PA)患者左室舒张功能精准评估的相关性。方法选择2017年1月—2018年12月于本院住院行PA筛查最终确诊为PA的患者45例和匹配相同年龄、性别、病程、血压水平的原发性高血压患者45例入组。通过脉冲多普勒测量二尖瓣舒张早期血流峰值流速(E)、舒张晚期血流峰值流速A以及E/A比值,应用组织多普勒技术分别测量室间隔二尖瓣瓣环处SEm、SAm、SEm/SAm、E/SEm及左室侧壁二尖瓣瓣环处LEm、LAm、LEm/LAm、E/LEm、等容舒张期时间间隔(IVRT),取两者平均值代表整体Em、Am、Em/Am、EEm,计算LEm/SEm及TDI-Tei指数。分析常规超声参数与组织多普勒超声参数的相关性。结果两组LEm、LAm、LEm/LAm、SEm、SAm、SEm/SAm、LEm/SEm对比具有显著性差异(P<0.05),两组E/SEm、E/LEm、IVRT、整体Em、整体Am、整体Em/Am、整体EEm、整体TDI-Tei指数对比具有显著性差异(P<0.05);相关性分析LEm/SEm与E/A呈正相关(r=0.426,P<0.05),与整体TDI-Tei指数、IVRT呈负相关(r=-0.513、-0.376,P<0.05),与整体Em和整体E/Em呈正相关(r=0.521、0.446,P<0.05),提示PA患者左室舒张功能明显降低,E/Em值与PA患者舒张功能评价具有临床意义。结论PA患者左室舒张功能出现一定程度改变,组织多普勒参数LEm/SEm、整体Em、整体EEm、整体TDI-Tei指数与左室舒张功能具有较好相关性,可作为评价PA早期左室舒张功能改变的影像指标,具有较高的临床应用价值。Objective To investigate the correlation between changes of tissue Doppler imaging parameters combined with Tei index and accurate assessment of left ventricular diastolic function in patients with primary aldosteronism( PA). Methods From January 2017 to December 2018,45 patients( 45 cases) with PA and 45 patients( 45 cases) with essential hypertension matching the same age,sex,course of disease and blood pressure level were enrolled in the study. The peak flow velocity( E),late diastolic peak flow velocity( A) and E/A ratio were measured by pulsed Doppler. SEm, SAm, SEm/SAm, E/SEm and LEm, LAm, LEm/LAm, E/LEm, IVRT at the interventricular septal mitral annulus were measured by tissue Doppler technique. The mean values represent the total Em,Am,Em/Am and E/Em of mitral annulus. The LEm/SEm ratio and TDI-Tei index were calculated. The correlation between conventional ultrasound parameters and tissue Doppler ultrasound parameters was analyzed. Results There were significant differences in LEm,LAm,LEm/LAm,SEm,SAm,SEm/SAm,and LEm/SEm between the two groups( P < 0. 05). The two groups were E/SEm,E/LEm,IVRT,overall Em,and overall Am. The overall Em/Am,overall EEm,and overall TDI-Tei index were significantly different( P < 0. 05);correlation analysis LEm/SEm was positively correlated with E/A( r = 0. 426,P < 0. 05),and overall TDI-Tei index and IVRT were negatively correlated( r =-0. 513,-0. 376,P < 0. 05),and positively correlated with the overall Em and overall E/Em( r = 0. 521,0. 446,P < 0. 05),suggesting that the left ventricle of PA patients The diastolic function was significantly reduced,and the E/E value was clinically significant in evaluating the diastolic function of patients with PA. Conclusion Left ventricular diastolic function of PA patients changed to a certain extent. Left ventricular diastolic function was correlated with tissue Doppler parameters LEm/SEm whole Em,whole E/Em combined whole TDI-Tei index. It can be used as an imaging index to evaluate the early changes of left ventricular diastolic func

关 键 词：原发性醛固酮增多症 组织多普勒参数 TEI指数 左室舒张功能 

分 类 号：R586.24[医药卫生—内分泌]