三维斑点追踪成像在不同类型高血压患者心功能指标检查中的对比研究  

Comparison study of 3D-STI in the examination of cardiac function of patients with different type of hypertension

作　　者：高辰玮[1] 曾伟 郑英娟[1] 刘伟亮[1] 徐大奎[1] 张宾 温德惠[1] GAO Chen-wei;ZENG Wei;ZHENG Ying-juan(Department of Ultrasound Medicine,The First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China;不详)

机构地区：[1]河北北方学院附属第一医院超声医学科,河北张家口075000 [2]解放军陆军第81集团军医院心肾内科,河北张家口075000 [3]河北北方学院附属第一医院心血管内科,河北张家口075000

出　　处：《中国医学装备》2021年第8期73-77,共5页China Medical Equipment

基　　金：河北省2020年度医学科学研究课题计划(20200200)“超声研究昼夜节律改变对老年高血压患者心血管靶器官的影响”;张家口市2020年市级科技计划自筹经费项目(2021086D)“急性心肌梗死患者经皮冠状动脉介入治疗术后早期心功能的超声评价”。

摘　　要：目的:利用三维斑点追踪成像(3D-STI)技术比较不同血压昼夜节律高血压患者左心室功能指标的差异,探讨夜间血压下降率与3D-STI参数相关性。方法:选取120例老年原发性高血压患者,根据血压昼夜节律不同分为杓型组和非杓型组,每组60例。所有患者均予以动态血压监测和超声心动图检查,比较两组患者超声心动图指标左室舒张末期室间隔厚度(IVSTd)、左室舒张末期左室后壁厚度(LVPWTd)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)和左室射血分数(LVEF),分析3D-STI参数整体纵向应变(OLS)、整体圆周应变(OCS)、整体面积应变(OAS)和整体径向应变(ORS)与夜间血压下降率的相关性。结果:两组常规超声心动图指标和GCS无统计学差异;非杓型组OLS、OAS和ORS均较杓型组显著降低,差异有统计学意义(t=-11.848,t=-6.790,t=5.772;P<0.05);夜间收缩压下降率与OAS独立相关(OR=2.115,P<0.05)。结论:相较于传统超声检查,3D-STI对于非杓型高血压患者心脏结构检查数据差异更明显,可用于非杓型高血压患者心脏疾病的预测。Objective:To compare the difference of left ventricular function of patients with hypertension of different blood pressure circadian rhythm by using three-dimensional speckle tracking imaging(3D-STI),and to explore the correlation between nocturnal blood pressure fall rate and 3D-STI parameters.Methods:120 elderly patients with essential hypertension who admitted to hospital were selected.And they were divided into dipper group and non-dipper group according to different circadian rhythms of blood pressure,with 60 cases in each group.All patients underwent ambulatory blood pressure monitoring and echocardiography,and the left ventricular end diastolic septal thickness(LVSTd),left ventricular posterior wall thickness(LVPWTd),left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV)and left ventricular ejection fraction(LVEF)of ultrasonic cardiogram indicators between two groups were compared.And the correlations between overall longitudinal strain(OLS),overall circumferential strain(OCS),overall area strain(OAS)and overall radial strain(ORS)of 3D-STI parameters and nocturnal blood pressure fall rate were analyzed.Results:There were no significant differences between indicators of conventionally ultrasonic cardiogram and OCS of two groups.The OLS,OAS and ORS of non-dipper group were significantly lower than those of dipper group(t=-11.848,t=-6.790,t=5.772,P<0.05).The nocturnal systolic blood pressure fall(SBPF)rate was positive correlation with OAS(t=2.115,P<0.040).Conclusion:Compared with conventional ultrasound examination,3D-STI has more obvious differences in the examination data of cardiac structural for patients with non-type hypertension,which can be applied to the prediction of heart disease of patients with non-dipper of hypertension.

关 键 词：高血压 左室舒张功能 三维斑点追踪成像(3D-STI) 动态血压 

分 类 号：R445.1[医药卫生—影像医学与核医学]