应用三维斑点追踪成像评价高尿酸血症对高血压患者左心室结构和功能的影响  

Evaluation of the effect of hyperuricemia on left ventricular structure and function in patients with hypertension using three-dimensional speckle tracking imaging

作　　者：赵洋 姜艳娜 徐升 王新贤 ZHAO Yang;JIANG Yan-na;XU Sheng;WANG Xin-xian(Department of Ultrasound,Liaoning Jinqiu Hospital,Shenyang 110016,China)

机构地区：[1]辽宁省金秋医院超声科,辽宁沈阳110016

出　　处：《中国临床医学影像杂志》2021年第2期108-111,116,共5页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨伴或不伴高尿酸血症的高血压患者左心室结构异常及其危险因素,应用三维斑点追踪技术(Three-dimensional speckle tracking imaging,3D-STI)评价其左心室收缩功能。方法:招募健康体检者40例(对照组),入选185例射血分数正常的原发性高血压患者(病例组),根据是否合并高尿酸血症分为单纯高血压组147例和高血压+高尿酸血症组38例。所有研究对象均进行常规及三维超声心动图检测,存储图像,应用多因素Logistic回归分析左心室重构的危险因素,应用3D-STI测量左心室整体纵向应变(GLS)、圆周应变(GCS)、面积应变(GAS)、径向应变(GRS),比较各测量值组间差异。结果:各组左心室形态构成比差异显著。与对照组相比,在两个高血压组中异常左室构型较多,左室肥厚在高血压+高尿酸血症组中最为普遍,血压和血尿酸是高血压患者左室重构的两个显著危险因素。与对照组相比,单纯高血压组GLS减低(P<0.05),GAS、GCS及GRS差异无明显统计学意义(P>0.05),高血压+高尿酸血症组GLS、GAS、GCS及GRS均减低(P<0.05);与单纯高血压组相比,高血压+高尿酸血症组GLS、GAS、GCS及GRS均减低(P<0.05)。结论:射血分数正常情况下,常规超声心动图结合3D-STI技术可以检测高血压伴或不伴高尿酸血症患者左心室结构异常及功能障碍。Objective:To investigate the left ventricular structural abnormalities and their risk factors in hypertensive patients with or without hyperuricemia,and to evaluate left ventricular systolic function by three-dimensional speckle tracking technique(3 D-STI).Methods:Forty healthy persons were recruited as control group.A total of 185 patients with hypertension preserved ejection fraction,as case group,were enrolled.These patients were divided into hypertension group(147 cases)and hypertension+hyperuricemia group(38 cases)according to whether the hyperuricemia was combined or not.All subjects underwent routine and three-dimensional echocardiography testing,images were stored,and risk factors for left ventricular remodeling were analyzed using multivariable Logistic regression,global longitudinal strain(GLS),circumferential strain(GCS),area strain(GAS)and radial strain(GRS)of left ventricle which were measured by 3 D-STI.Results:There was significant difference in the ratio of left ventricular morphology in each group.Compared with the control group,there were more abnormal left ventricular configurations in the two hypertension groups,and left ventricular hypertrophy was the most sign common in hypertension+hyperuricemia group.Compared with the control group,the GLS of hypertension group decreased(P<0.05),the GLS,GAS,GCS and GRS of hypertension+hyperuricemia group decreased(P>0.05),and the GLS,GAS,GCS and GRS of hypertension+hyperuricemia group decreased(P<0.05).Compared with the hypertension group,the GLS,GAS,GCS and GRS were decreased in hypertension+hyperuricemia group(P<0.05).Conclusion:With a normal ejection fraction,conventional echocardiography combined with 3 D-STI technique can detect structural abnormalities and dysfunction of the left ventricle in hypertensive patients with or without hyperuricemia.

关 键 词：高尿酸血症 高血压 心室功能 左 超声心动描记术 多普勒 彩色 

分 类 号：R589.7[医药卫生—内分泌] R331.31[医药卫生—内科学]