声学密度技术对老年人高血压左房心肌纤维化的临床评价

Clinical evaluation of left atrial myocardial fibrosis in senile patients with hypertension by acoustic densitometry technology

目的探讨声学密度计量(acoustic densitom etry,AD)技术对评价老年人高血压左房心肌纤维化程度的临床应用价值。方法老年高血压病患者54例分为高血压I型前胶原羧基端前肽(PICP)<127μg/L组和高血压PICP>127μg/L组,健康对照20例。AD技术分别测定左房后壁、左房腔及心包的时间平均图像强度(AII)与心动周期变化幅度(PPI)。放免法测定血清PICP。结果与对照组相比,高血压组AII值明显升高;高血压PICP>127μg/L组AII值明显高于PICP<127μg/L组。各组间PPI值变化呈相反趋势。左房后壁AII,经心包及经心腔标化的左房后壁AII均与PICP呈正相关关系,与PC III无直线相关关系。结论AD技术是检测老年人高血压左房心肌纤维化程度敏感而可行的方法。

Objective To investigate clinical value of acoustic densitometry technology in elder hypertensive patients with left atrial myocardial fibrosis. Methods 54 elder essential hypertensive patients with left atrial myocardial fibrosis and 20 normotensive subjects were enrolled. The former was divided by carboxyterminal propeptide of type I procollagen （PICP） into essential hypertensive patients with PICP 〉 127 μg/L and essential hypertensive patients with PICP 〈 127 μg/L. The posterior wall （PW） of left atrium, the correspondent pericardium and atrial chamber were selected for detecting average acoustic intensity （AII） and cyclic variation of integrated hackscattey （ peak to peak intensity, PPI）. The serum concentrations of PICP were measured by specific radioimmunoassay. Results Compared with the healthy controls, AII in essential hypertensive patients showed a significant increase, among which AII in essential hypertensive patients with PICP 〉 127 μg/L was significantly higher than that in essential hypertensive patients with PICP 〈 127 μg/L, while the changes of PPI among 3 groups were just on the contrary. AII of PW of left atrium, and thorpe corrected by pericardium and left atrial chamber were correlated positively with the serum concentrations of PICP, but not correlated with serum concentrations of PCIII. Conclusions Acoustic densitometry technology is feasible and sensitive in detecting and monitoring the degree of left atrial myocardial fibrosis in elder essential hypertensive patients.