四维应变成像技术在青年H型高血压患者左室心肌收缩功能评估中的应用研究  

Application research of four-dimentional strain imaging technology in the evaluation of left ventricular myocardium systolic function for young patients with H-type hypertension

作　　者：马振[1] 刘雪玲[2] 苏虹月 韦芳[2] 钟云青[3] MA Zhen;LIU Xueling;SU Hongyue;WEI Fang;ZHONG Yunqing(Department of Ultrasonography,Guangxi International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine,Nanning 530203,Guangxi,China;Department of Ultrasonography,the First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530020,Guangxi,China;Department of Pulmonary Disease,Guangxi International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine,Nanning 530203,Guangxi,China)

机构地区：[1]广西中医药大学附属国际壮医医院超声科,广西南宁市530203 [2]广西中医药大学第一附属医院超声科,广西南宁市530020 [3]广西中医药大学附属国际壮医医院肺病科,广西南宁市530203

出　　处：《微创医学》2022年第2期149-153,共5页Journal of Minimally Invasive Medicine

基　　金：国家自然科学基金项目(编号:2017-38-2057);广西卫生健康委员会科研课题(编号:Z2016676);广西卫生健康委员会科研课题(编号:GZZC2019062);广西中医药大学博士科研启动基金(编号:2020BS033);广西中医药大学教改课题(编号:2017C23)。

摘　　要：目的探讨四维应变成像(4D-SI)技术评估青年H型高血压病患者左室心肌整体收缩功能的临床应用价值。方法选取89例青年高血压患者,将43例血浆同型半胱氨酸(Hcy)>15μmol/L的患者纳入青年H型高血压组,将46例血浆Hcy≤15μmol/L的患者纳入青年高血压组,另选52例健康志愿者作为对照组。对比3组研究对象的血压及二维超声心动图心脏功能参数,并应用4D-SI比较3组左室整体纵向峰值应变(GLS)、左室整体圆周峰值应变(GCS)、左室整体面积峰值应变(GAS)、左室整体径向峰值应变(GRS)。结果青年H型高血压组、青年高血压组患者的收缩压、舒张压高于对照组(均P<0.05),但两组间比较差异无统计学意义(均P>0.05)。青年H型高血压组、青年高血压组的舒张末期室间隔厚度(IVSd)、舒张末期左室后壁厚度(LVPWd)、左室心肌质量指数(LVMI)高于对照组(均P<0.05),但两组间上述指标比较差异无统计学意义(均P>0.05)。3组的左室射血分数(LVEF)、早期二尖瓣血流速度/早期二尖瓣环运动速度的比值(E/Em)均在正常参考范围内,且3组比较差异无统计学意义(均P>0.05)。青年H型高血压组、青年高血压组的GLS、GAS低于对照组,且青年H型高血压组水平低于青年高血压组(均P<0.05)。青年H型高血压组的GCS、GRS低于青年高血压组、对照组(均P<0.05),而青年高血压组和对照组的GCS、GRS比较,差异无统计学意义(均P>0.05)。结论4D-SI技术可发现青年H型高血压患者左室心肌收缩功能的早期亚临床改变,并且能够提供较为准确的定量评估,为临床防治高血压提供客观的参考依据。Objective To explore the clinical application value of four-dimentional strain imaging(4D-SI)technology for evaluating integral systolic function of left ventricular myocardium in young patients with H-type hypertension.Methods A total of 89 young patients with hypertension were selected,among which 43 patients with plasma homocysteine(Hcy)>15μmol/L were enrolled in the young H-type hypertension group,whereas 46 patients with plasma Hcy≤15μmol/L in the young hypertension group;meanwhile,another 52 healthy volunteers were selected as the control group.The blood pressure,and cardiac function parameters via two-dimentional echocardiogram were compared between the three groups;furthermore,4D-SI was employed to compare the global longitudinal strain(GLS),global circumferential strain(GCS),global area strain(GAS),and global radial strain(GRS)between the three groups.Results Both young H-type hypertension and young hypertension groups interpreted higher systolic and diastolic pressures as compared with the control group(all P<0.05),but there were no statistically significant differences between the two groups(all P>0.05).To compared with the control group,both young H-type hypertension and young hypertension groups yielded higher interventricular septum thickness at the end of diastole(IVSd),left ventricular posterior wall thickness at the end of diastole(LVPWd),left ventricular mass index(LVMI)(all P<0.05),but no statistically significant difference of aforesaid indicators expressed in both groups(all P>0.05).The left ventricular ejection fraction(LVEF),the ratio of early transmitral flow velocity to early mitral annular velocity(E/Em)of the three groups were within the normal reference range,and there were no statistically significant differences between the three groups(all P>0.05).Both young H-type hypertension and young hypertension groups implied lower GLS and GAS as compared with the control group,and the young H-type hypertension group had lower levels as above than the young hypertension group(all P<0.05).T

关 键 词：四维应变成像 H型高血压 左室心肌整体收缩功能 青年 

分 类 号：R445.1[医药卫生—影像医学与核医学]