超声心动图对高血压前期患者左心结构与功能改变的预测价值  

VALUE OF ECHOCARDIOGRAPHY IN PREDICTING THE CHANGES IN LEFT HEART STRUCTURE AND FUNCTION IN PATIENTS WITH PREHYPERTENSION

作　　者：孙品[1] 韩伟东 郭艳杰 王小凡[1] 吕启凤[1] 宋晓霞[1] 田雨[1] 何香芹[1] 姜志荣[1] SUN Pin;HAN Weidong;GUO Yanjie;WANG Xiaofan;LV Qifeng;SONG Xiao-xia;TIAN Yu;HE Xiangqin;JIANG Zhirong(Department of Cardiac Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao 266003, China)

机构地区：[1]青岛大学附属医院心脏超声科,山东青岛266003 [2]潍坊市人民医院超声科

出　　处：《精准医学杂志》2020年第6期519-521,525,共4页Journal of Precision Medicine

基　　金：青岛市南科技局项目(2016-3-025-YY)。

摘　　要：目的应用超声心动图观察青岛地区高血压前期患者左心结构与功能的变化,探讨其在预测左心功能中的应用价值,为高血压前期患者的早期干预提供参考依据。方法选取于我院心内科门诊行超声心动图检查的高血压前期患者160例(高血压前期组)和血压正常者160例(对照组),记录受检者血压。按照美国超声心动图学会(ASE)推荐的方法,测量受检者左心房内径、左心室舒张末内径、左心室收缩末内径、室间隔厚度、左心室后壁厚度、二尖瓣环舒张早期和舒张晚期峰值速度Em与Am、二尖瓣前向血流频谱E峰与A峰、左心室射血分数,并计算左心室质量指数、E/A、Em/Am,分析左心结构与功能指标的变化。并探讨超声心动图参数与血压水平之间的相关性。结果高血压前期组患者左心房内径、左心室质量指数及Em/Am比值与对照组比较,差异有显著性(t=3.06~5.43,P<0.05);两组左心室舒张末内径、左心室收缩末内径、室间隔厚度、左心室后壁厚度、E/A比值、左心室射血分数比较差异无显著性(P>0.05)。相关性分析显示,高血压前期组患者左心房内径、左心室质量指数与收缩压呈正相关(r=0.406、0.345,P<0.05),Em/Am与患者收缩压呈负相关(r=-0.366,P<0.05);左心房内径、左心室质量指数与患者平均动脉压呈正相关(r=0.267、0.339,P<0.05),Em/Am与患者平均动脉压呈负相关(r=-0.302,P<0.05)。结论高血压前期组患者已经出现左心房增大、左心室质量指数增加及舒张功能减低等结构与功能的改变,超声心动图可早期预测高血压前期患者的左心功能。Objective\To investigate the changes in left heart structure and function in patients with prehypertension in Qingdao,China using echocardiography and the value of echocardiography in predicting left heart function,and to provide a refe-rence for the early intervention of patients with prehypertension.\Methods\A total of 160 patients with prehypertension and 160 patients with normal blood pressure who underwent echocardiography in the outpatient service of Department of Cardiology in our hospital were enrolled as prehypertension group and control group,respectively,and their blood pressure was recorded.The met-hods recommended by American Society of Echocardiography were used to measure left atrial diameter,left ventricular end-diastolic diameter,left ventricular end-systolic diameter,interventricular septal thickness,left ventricular posterior wall thickness,early and late diastolic mitral annular peak velocities(Em and Am,respectively),mitral peak early diastolic filling velocity and mitral peak late diastolic filling velocity,and left ventricular ejection fraction,and left ventricular mass index,mitral ratio of peak early to late diastolic filling velocity(E/A ratio),and Em/Am ratio were calculated to analyze the changes in left heart structure and function.The correlation between echocardiographic parameters and blood pressure was analyzed.\Results\There were significant differences in left atrial diameter,left ventricular mass index,and Em/Am ratio between the prehypertension group and the control group(t=3.06-5.43,P<0.05),while there were no significant differences between the two groups in left ventricular end-diastolic diameter,left ventricular end-systolic diameter,interventricular septal thickness,left ventricular posterior wall thickness,E/A ratio,and left ventricular ejection fraction(P>0.05).The correlation analysis showed that in the prehypertension group,left atrial diameter and left ventricular mass index were positively correlated with systolic pressure(r=0.406,0.345,P<0.05),and Em/Am ratio was n

关 键 词：超声心动描记术 高血压前期 心房功能 左 心室功能 左 预测 早期医疗干预 

分 类 号：R540.45[医药卫生—心血管疾病] R543[医药卫生—内科学]