应用无创压力应变环评估原发性高血压患者左室心肌做功的临床价值  

Clinical value of non-invasive pressure-strain loop in assessing left ventricular myocardial work in patients with primary hypertension

作　　者：丁俊 孙红光[1] 鞠萍[1] 秦爱平 吴丹[2] Ding Jun;Sun Hongguang;Ju Ping;Qin Aiping;Wu Dan(Department of Ultrasound,Medical Imaging Center,Affiliated Hospital of Yangzhou University,Yangzhou 225001,China;Department of Cardiovascular Medicine,Affiliated Hospital of Yangzhou University,Yangzhou 225001,China)

机构地区：[1]扬州大学附属医院医学影像中心超声科,扬州225001 [2]扬州大学附属医院心血管内科,扬州225001

出　　处：《中华健康管理学杂志》2023年第11期821-827,共7页Chinese Journal of Health Management

基　　金：扬州市“十三五”科教强卫领军人才项目(LJRC201819)。

摘　　要：目的分析应用无创压力应变环(PSL)评估原发性高血压患者左室心肌做功的临床价值。方法本研究为横断面研究,连续纳入2020年8—12月就诊于扬州大学附属医院的66例原发性高血压患者为研究对象,根据左室质量指数(LVMI)女性>95 g/m2、男性>115 g/m2和女性≤95 g/m2、男性≤115 g/m2分为左室肥厚(LVH)组(14例)和非左室肥厚(NLVH)组(52例),并进一步根据收缩压140~159 mmHg(1 mmHg=0.133 kPa)和≥160 mmHg将NLVH组分为轻度组(30例)和中重度组(22例),另收集同期来院体检的25例健康成人作为健康对照组。测量各组身高、体重、血压,并进行常规超声心动图及斑点追踪成像分析,将斑点追踪分析结果与血压结合得出PSL结果,比较各组一般临床资料、二维超声基本参数及PSL的心肌做功参数(整体做功指数、整体有效功、整体无效功、整体做功效率)差异,分析应用PSL评估原发性高血压患者左室心肌做功的临床价值。结果各组左室射血分数差异均无统计学意义(均P>0.05)。NLVH中重度组整体做功指数显著高于NLVH轻度组、LVH组及健康对照组[(2630±231)比(2254±179)、(1847±261)、(1724±209)mmHg%],整体有效功显著高于LVH组及健康对照组[(2965±261)比(2330±258)、(2121±163)mmHg%](均P<0.05);LVH组整体无效功显著高于NLVH中重度组、NLVH轻度组及健康对照组[(248±107)比(141±57)、(116±57)、(83±58)mmHg%],整体做功效率显著低于NLVH中重度组、NLVH轻度组及健康对照组(89.1%±3.9%比94.3%±1.9%、95.0%±1.8%、95.8%±2.3%)(均P<0.05)。随着血压的升高,LVH组PSL变小,其余3组PSL变大;健康对照组心肌做功牛眼图为均匀的绿色(正常有效做功区),NLVH轻度组开始出现红色(高心肌做功区),NLVH中重度组红色区域增加,LVH组出现蓝色(无效做功区)。结论应用PSL评估原发性高血压患者左室心肌做功具有较好的临床价值,其得出的心肌做功各参数数据可灵敏识别左室射Objective To analyze the clinical value of noninvasive pressure strain loop(PSL)in assessing left ventricular myocardial work in patients with essential hypertension.Methods In this cross-sectional study,66 patients with essential hypertension who were admitted to the Affiliated Hospital of Yangzhou University from August to December 2020 were continuously enrolled.According to left ventricular mass index(LVMI)>95 g/m2 in women and>115 g/m2 in men,≤95 g/m2 in women and≤115 g/m2 in men,the 66 patients were divided into left ventricular hypertrophy(LVH)group(14 cases)and non-left ventricular hypertrophy(NLVH)group(52 cases).Furthermore,the NLVH group was divided into a mild group(30 cases)and a moderate/severe group(22 cases)according to the systolic blood pressure of 140~159 mmHg(1 mmHg=0.133 kPa)and≥160 mmHg.Another 25 healthy adults who underwent physical examination during the same period were included as healthy control group.The height,weight and blood pressure were measured in all the subjects,and routine echocardiography and speckle tracking imaging analysis were performed.PSL results were obtained by combining the results of speckle tracking imaging analysis with systolic blood pressure.The differences of general clinical data,basic parameters of two-dimensional ultrasound and myocardial work parameters of PSL(global work index,global effective work,global wasted work,and global work efficiency)were compared among the groups,and the clinical value of PSL in assessing left ventricular myocardial work in patients with essential hypertension was analyzed.Results There was no significant difference in left ventricular ejection fraction among all groups(all P>0.05).The global work index of moderate/severe NLVH group was significantly higher than that of mild NLVH group,LVH group and healthy control group[(2630±231)vs(2254±179),(1847±261),(1724±209)mmHg%].The global effective work of moderate/severe NLVH group was significantly higher than that of LVH group and healthy control group[(2965±261)vs(2330�

关 键 词：高血压 无创压力应变环 心肌做功 

分 类 号：R544.11[医药卫生—心血管疾病]