左室压力-应变环评估原发性高血压不同分级患者心肌功能障碍的价值  

Evaluation of Myocardial Work in Patients with Different Grades of Essential Hypertension By Left Ventricle Pressure-strain Loop

作　　者：陈丽丽 章春泉[1] 郭良云[1] 王小林 刘凤珍 赵玙[1] 李霞[1] Chen Lili;Zhang Chunquan;Guo Liangyun;Wang Xiaolin;Liu Fengzhen;Zhao Yu;Li Xia(Department of Ultrasound,the Second Affiliated Hospital of Nanchang University,Nanchang,Jiangxi 30006,China)

机构地区：[1]南昌大学第二附属医院超声科,南昌市330006

出　　处：《中国超声医学杂志》2021年第5期535-538,共4页Chinese Journal of Ultrasound in Medicine

基　　金：江西省教育厅科学技术研究项目(No.GJJ190002)。

摘　　要：目的应用超声心动图左室压力-应变环(LVPSL)定量评价原发性高血压不同分级患者心肌做功情况,探讨LVPSL在评估原发性高血压(EHP)患者心肌功能障碍中的应用价值。方法选取我院就诊的EHP患者160例,其中高血压1级组52例,高血压2级组72例,高血压3级组36例,另选取健康志愿者42例,作为正常血压组。应用LVPSL评估每位受试者心肌做功状况,其参数包括整体有用功(GCW)、整体无用功(GWW)、整体做功指数(GWI)、整体做功效率(GWE),同时比较各组间左室整体纵向应变(GLS)、达峰时间离散度(PSD),观察四组间上述参数的差异。结果四组间GWW、GWE、GLS、PSD的差异具有统计学意义。随着血压分级的增高,GWW、PSD呈逐渐增大趋势,而GWE、GLS绝对值逐渐下降;GWW、GWE在高血压2级组与3级组患者比较差异有统计学意义,而斑点追踪超声心动图GLS无统计学意义。结论LVPSL可早期评估EHP患者心肌功能障碍,GWW、GWE在高血压2级组与3级组患者心肌功能障碍鉴别中较斑点追踪超声心动图GLS灵敏。Objective We investigate the differences of myocardial work parameters measured by non-invasive left ventricular pressure-strain loop(LVPSL)in patients with essential hypertension(EHP)to explore the application value of LVPSL in the evaluation of myocardial dysfunction in patients with EHP.Methods A total of 160 newly diagnosed patients with EHP in our hospital were selected and divided into hypertension grade 1,hypertension grade 2 and hypertension grade 3.Another 42 healthy subjects were selected as a normal blood pressure group.LVPSL was used to evaluate the myocardial work parameters of each subject,including global constructive work(GCW),global work waste(GWW),global work index(GWI),global work efficiency(GWE).Then included the overall global longitudinal strain(GLS)and peak strain dispersion(PSD);to compare the differences of the above parameters between the four groups.Results The differences of GWW,GWE,GLS and PSD among the four groups were statistically significant.With the increase of blood pressure grade,GWW and PSD increased gradually,while GWE and the absolute values of GLS decreased gradually,in which GWW and GWE could distinguish the slight difference between hypertension grade 2 group and grade 3 group.Conclusions LVPSL can early evaluate myocardial dysfunction in patients with EHP,even earlier than two-dimensional speckle tracking echocardiography.

关 键 词：左室压力-应变环 心肌做功 原发性高血压 

分 类 号：R445.1[医药卫生—影像医学与核医学] R544.11[医药卫生—诊断学]