多普勒超声心动图对高血压病左室舒张功能的探讨

Evaluation of left ventricular diastolic function in essential hypertension patients by Dopper echocardiography

目的探讨高血压(EH)患者左室舒张功能的情况。方法用二维超声心动图及Doppler频谱检测80例患者的左室舒张功能,其中左室肥厚组(LVH)38例,非左室肥厚组(NLVH)42例,并与40例正常人对照。结果在NLVH组和LVH组与正常对照组比较,E/A比值减低、PA值和PAi增高有显著差异;LAT减低及IRT延长,在3组之间有显著差异;EF%值在NLVH组和正常对照组相似,而在LVH组减低,其差异有统计学意义。结论EF值变化提示EH早期左室收缩功能并未受到影响,随着疾病进展而逐步受损。应用同时反映左室收缩功能和舒张功能的Tei指数(C)的研究结果表明正常对照组和EH组存在显著性差异。左房灌注分数(LAT)是比二尖瓣及肺静脉血流频谱更加可靠地反映早期左室舒张功能异常的指标。

Objective To assess left ventricular diastolic function in the patients with essential hypertension by Doppler echocardography.Methods 40 normotensives, 38 with hypertrophy（LVH） and 42 hypertensives without hypertrophy（NLVH） underwent 2DE and Doppler eehocardiography. Results E/A ratio, PA and PAi wave had significant differences in LVH patients and NLVH patients with norrnotensives. The isovolumic relaxation time（IRT） and left atrial function（LAT） had significant differences in three groups （P 〈 0.05-0.01 ）;EF value was similar between normotensives and NLVH patients, but it was lower in LVH patients（ P 〈 0.01 ） .Conclusion Sensitive parameters indicating mild diastolic left ventrieular dysfunction . Systolic left ventricular function has no change in NLVH patients. Spectral Doppler echocardiography is a practical and reliable technique in the noninvasive assessment of the left ventricular diastolic dysfunction in patients with essential hypertension. Left atrial function can indicate the echocardiographic change of left ventricular remoderling in earlier stage.