四维自动左房定量技术评估原发性高血压病患者左房功能的价值  

Value of four-dimensional automated left atrial quantification technique in the assessment of left atrial function in patients with essential hypertension

作　　者：徐明媛 欧艳梅 李丕宇 冷晓萍[1] XU Mingyuan;OU Yanmei;LI Piyu;LENG Xiaoping(Department of Ultrasound Medicine,the Second Affiliated Hospital of Harbin Medical University,Harbin 150086,China)

机构地区：[1]哈尔滨医科大学附属第二临床医院超声医学科,哈尔滨市150086

出　　处：《临床超声医学杂志》2022年第6期401-405,共5页Journal of Clinical Ultrasound in Medicine

基　　金：国家自然科学基金项目(81971626);黑龙江省重点研发计划项目(GA21D007)。

摘　　要：目的探讨四维自动左房定量(4D AUTO LAQ)技术评估原发性高血压病(EH)患者左房功能的临床应用价值。方法选取于我院就诊的EH患者99例,根据左室质量指数(LVMI)分为非左室壁肥厚组53例(NLVH组)和左室壁肥厚组46例(LVH组),另选血压正常的健康体检者48例为对照组。应用常规超声心动图检测各组左房内径(LADs)、左室舒张末期内径(LVDd)、左室收缩末期内径(LVDs)、舒张期左室后壁厚度(LVPWT)、舒张期室间隔厚度(IVS)、左室质量(LVM)、左室质量指数(LVMI)、左室射血分数(LVEF)、二尖瓣口舒张早期和晚期峰值流速(E、A)、二尖瓣环舒张早期运动速度峰值(e’)、E/e’,4D AUTO LAQ技术检测左房容积和应变参数,包括左房最大容积(LAVmax)、左房最小容积(LAVmin)、左房收缩前容积(LAVpreA)、左房容积指数(LAVI)、左房射血分数(LAEF)、左房储备期纵向应变(LASr)、左房导管期纵向应变(LAScd)、左房收缩期纵向应变(LASct)、左房储备期圆周应变(LASr-c)、左房导管期圆周应变(LAScd-c)、左房收缩期圆周应变(LASct-c),比较各组上述参数的差异。绘制受试者工作特征(ROC)曲线分析左房应变参数评估EH患者左房功能改变的效能。结果常规超声心动图检查结果显示,与对照组比较,NLVH组LVDd、IVS、LVPWT、LVM、LVMI、A、E/e’均增大,e’减小,差异均有统计学意义(均P<0.05);LVH组LADs、LVDd、LVDs、IVS、LVPWT、LVM、LVMI、A、E/e’均增大,LVEF、e’均减小,差异均有统计学意义(均P<0.05)。与NLVH组比较,LVH组LADs、LVDd、IVS、LVPWT、LVM、LVMI均增大,差异均有统计学意义(均P<0.05)。4D AUTO LAQ检查结果显示,与对照组比较,NLVH组LAVmax、LAVmin、LAVpreA均增大,LASr、LAScd均减小,差异均有统计学意义(均P<0.05);LVH组LAVmax、LAVmin、LAVI、LAVpreA均增大,LAEF、LASr、LAScd、LASct、LASr-c、LASct-c均减小,差异均有统计学意义(均P<0.05)。与NLVH组比较,LVH组LAVmax、LAVmin、LAObjective To investigate the clinical application valueof four-dimensional automated left atrial quantification(4D AUTO LAQ)technique in assessing left atrial function in patients with essential hypertension(EH).Methods nine EH patients treated in our hospital were enrolled.According to the left ventricular mass index(LVMI),the patients were divided into non-left ventricular hypertrophy(NLVH)group(n=53)and left ventricular hypertrophy(LVH)group(n=46).Healthy subjects with normal blood pressure were enrolled as the control group(n=48).Conventional echocardiography parameters including left atrial diameter(LADs),left ventricular end-diastolic and-systolic diameter(LVDd and LVDs),left ventricular posterior wall thickness(LVPWT),interventricular septal thickness(IVS),left ventricular mass(LVM),left ventricular mass index(LVMI),left ventricular ejection fraction(LVEF),early diastolic transmitral inflow velocity(E),late diastolic transmitral inflow velocity(A),peak velocity of the transmitral annulus early diastole(e’)and E/e’were measured.4D AUTO LAQ technique was used to measure the volume and strain parameters of left atrial,including left atrial maximum volume(LAVmax),left atrial minimum volume(LAVmin),left atrial volume before A wave(LAVpreA),left atrial volume index(LAVI),left atrial ejection fraction(LAEF),left atrial reservoir phase longitudinal strain(LASr),left atrial ductal phase longitudinal strain(LAScd),left atrial systolic phase longitudinal strain(LASct),left atrial reservoir phase circumferential strain(LASr-c),left atrial ductal phase circumferential strain(LAScd-c)and left atrial systolic phase circumferential strain(LASct-c).The differences of the above parameters in each group were compared.The receiver operating characteristic(ROC)curve was drawn to analyze the efficacy of left atrial strain parameters in evaluating left atrial function changes in EH patients.ResultsThe results of conventional echocardiography showed that,compared with the control group,LVDd,IVS,LVPWT,LVM,LVMI,A,E/e’in the N

关 键 词：四维自动定量技术 高血压病 原发性 心房功能 心室功能 左 

分 类 号：R540.45[医药卫生—心血管疾病] R322.1[医药卫生—内科学]