背向散射技术与彩色室壁运动技术在高血压左室重构中的应用  

Application of Ultrasonic Integrated Backscatter and Color Kinesis in Essential Hypertensive Patients with Left Ventricular Remodeling

作　　者：刘晓宁[1] 夏稻子[1] 

机构地区：[1]大连医科大学附属第二医院超声科,辽宁大连116023

出　　处：《高血压杂志》2003年第6期535-539,共5页Chinese Journal of Hypertension

摘　　要：目的　探讨背向散射和彩色室壁运动参数评估原发性高血压不同左室构型心肌病变程度和局部室壁运动的临床价值。方法　测定 70例原发性高血压病患者和 3 1例正常对照者室间隔及左室后壁的背向散射参数和局部室壁收缩期位移。共收入正常构型组 18例 ,向心重构组 17例 ,向心肥厚组 2 3例 ,离心肥厚组 12例。结果　高血压各组室间隔超声背向散射 (IB % )均不同程度地增大 ,以向心性肥厚组和离心性肥厚组为著 ;左室后壁IB %在向心性肥厚组和离心性肥厚组增高 ,以离心性肥厚组为著 ;室间隔周期变化幅度 (CVIB)在向心性肥厚组和离心性肥厚组减低 ;左室后壁的CVIB在离心性肥厚组显著减低 ;高血压各组均未出现明显的背向散射跨壁梯度的改变。室间隔和左室后壁的SEM在离心性肥厚组显著减低 ,其余各组间虽无明显统计学差异 ,但在向心性肥厚组呈现增加的趋势。在离心性肥厚组 ,收缩期CK色带变薄或消失 ,色带不完整。结论　心肌超声背向散射参数可用于判断高血压不同左室构型心肌病变的程度 ;Objective To evaluate the clinical appli cation of ultrasonic integrated backscatter(IB) and color kinesis parameters to assess the lesion of myocardium and regional wall motion in essential hypertensive patients with different left ventricular geometries. Methods In 70 cases of essential hypertensive pat ients and 31 normal cases, the myocardial ultrasonic integrated backscatter parameters and regional endocardial motion parameters were measured. The LV geometry in hypertension was categorized as: normal (n=18), concentric remodeling(n=17), concentric hypertrophy (n=23), and eccentric hypertrophy(n=12). Results IB% of interventricle se ptum was increased in all hypertension groups. Most pronounced changes were found in concentric and eccentric hypertrophy groups; LVPW-IB% was increased in concentric and eccentric hypertrophy groups. IVS-CVIB was decreased in both concentric and eccentri c hypertrophy groups; LVPW-CVIB decreased in eccentric hypertrophy group. Transmural gradient in myocardial ultrasonic integrated backscatter were not present in essential hypertensive patients. Systolic endocardium motion(SEM) of IVS and LVPW was decreased in eccentric hypertrophy group, an increased tendency in concentric hypertrophy group was shown. In eccentric hypertrophy group, the color bands was thin or disappear, and the color stratification was not integrant in end-systolic CK images. Conclusi on Ultrasonic integrated backscatter parameters are valuable in determination of the degree of myocardial injury in essential hypertensive patients with different left ventricular geometries;color kinesis parameters are useful in the assessment of the regional wall motion.

关 键 词：背向散射 彩色室壁运动 高血压 左室重构 心肌病变 

分 类 号：R541.3[医药卫生—心血管疾病]