实时三维超声心动图评估降压治疗对老年原发性高血压病患者右室结构及功能的影响  

Effect of antihypertensive treatment on right ventricular structure and function in elderly patients with essential hypertension by real-time three-dimensional echocardiography

作　　者：高旭宏 赵瑞环 康春松[2] GAO Xuhong;ZHAO Ruihuan;KANG Chunsong(College of Medical Imaging,Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学医学影像学院,太原市030001 [2]山西医科大学附属山西白求恩医院超声科

出　　处：《临床超声医学杂志》2021年第8期604-607,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的应用实时三维超声心动图(RT-3DE)评估降压治疗对老年原发性高血压病患者右室结构及功能的影响。方法选取我院老年原发性高血压病患者97例和同期50例无心脏结构和功能异常、无心脑血管疾病的老年健康体检者(对照组),其中97例高血压病患者根据左室质量指数(LVMI)分成LVMI正常组(50例)及LVMI增高组(47例),均行降压治疗,于治疗前、24个月后行超声心动图检查获取右室舒张末期容积(RVEDV)、右室收缩末期容积(RVESV)、右室每搏输出量(RVSV)、右室射血分数(RVEF)、三尖瓣环收缩期位移(TAPSE)、右室面积变化分数(FAC)及舒张早期三尖瓣口血流速度与三尖瓣环运动速度比值(E/e’)。比较降压治疗前后各组上述参数变化。结果(1)降压治疗前:与对照组比较,LVMI正常组TAPSE、FAC均减小,E/e’增大,差异均有统计学意义(均P<0.05);LVMI增高组RVEDV、RVESV及E/e’增大,RVEF、TAPSE、FAC均减小,差异均有统计学意义(均P<0.05);与LVMI正常组比较,LVMI增高组RVEF减小,TAPSE、E/e’增大,差异均有统计学意义(均P<0.05)。(2)降压治疗后:LVMI正常组TAPSE及LVMI增高组RVEF、TAPSE均增大,LVMI增高组E/e’减小,与降压治疗前比较差异均有统计学意义(均P<0.05);LVMI增高组RVEDV、E/e’均较LVMI正常组增大,差异均有统计学意义(均P<0.05);其他参数比较差异均无统计学意义。结论原发性老年高血压病患者右室发生重构及功能受损,LVWI增高者更甚;经降压治疗可使其右室结构及功能明显改善;RT-3DT可准确评估降压治疗对老年原发性高血压病患者右室结构及功能的影响。Objective ventricle in elderly patients with essential hypertension by real-time three-dimensional echocardiography(RT-3 DE).Methods cardiac structure and function abnormalities and without cardiovascular and cerebrovascular diseases(control group)in the same period were selected.97 patients with hypertension were divided into normal left ventricular mass indes(LVMI)group(50 cases)and high LVMI group(47 cases),and all the patients received antihypertensive treatment.Before treatment and 24 months later,echocardiography was performed to obtain right ventricular end-diastolic volume(RVEDV),right ventricular end-systolic volume(RVESV),right ventricular stroke volume(RVSV),right ventricular ejection fraction(RVEF),tricuspid annulus systolic displacement(TAPSE),right ventricular area change fraction(FAC)and the ratio of early diastolic tricuspid flow velocity to tricuspid annulus velocity.The changes of the above parameters were compared before and after the antihypertensive treatment.Results(1)Before antihypertensive treatment:compared with the control group,TAPSE and FAC were decreased,and E/e’was increased in the normal LVMI group,and the differences were statistically significant(all P<0.05).Compared with the control group,RVEDV,RVESV and E/e’were increased,RVEF,TAPSE and FAC were decreased in the high LVMI group,and the difference were statistically significant(all P<0.05).(2)Compared with before treatment,TAPSE in the normal LVMI group and RVEF and TAPSE in the high LVMI group were increased,while E/e’was decreased in the high LVMI group,and the difference were statistically significant(all P<0.05).RVEDV and E/e’in the high LVMI group were increased compared with the normal LVMI group,and the difference were statistically significant(both P<0.05).There were no statistically significant differences in other parameters.Conclusion with hypertension,and it is more serious when LVMI is increased.Antihypertensive treatment can significantly improve the structure and function of the right ventricle.RT-3 DE can

关 键 词：超声心动描记术 三维 实时 高血压病 原发性 老年 左室质量 心室功能 右 

分 类 号：R540.45[医药卫生—心血管疾病] R544.1[医药卫生—内科学]