校正Tei指数在高血压患者左心室功能评价中的应用

Applicability of modified Tei index in assessing left ventricular function in patients with hypertension

目的对比观察传统Tei指数和校正Tei指数对高血压患者左心室功能的评价。方法初诊为高血压未经抗高血压治疗的67例患者根据左心室重量指数分为两组,无心肌肥厚组(A组)32例,心肌肥厚组(B组)35例,另选24例健康体检者为对照组。所有入选者均进行超声心动图、二尖瓣血流频谱和组织多普勒超声显像检查,根据相应公式计算Tei指数和校正Tei指数。结果左心室射血分数在3组间无显著性差异,心肌收缩峰值速度在3组间虽然无显著性差异,但B组较对照组升高明显。二尖瓣瓣尖水平E峰血流速度、E峰血流速度/A峰血流速度以及心肌运动频谱舒张早期峰值速度和舒张早期峰值速度/舒张晚期峰值速度在A、B两组患者显著降低,尤其以B组明显。结论校正Tei指数同传统Tei指数一样能够灵敏准确地评价高血压患者左心室的整体功能,并与传统Tei指数具有很高的相关性。

Objective To compare the value of modified Tei index and Tei index in assessing left ventricular function in patients with hypertension. Methods Sixty-seven patients with mild/moderate hypertension were divided into 2 groups. Thirty-two patients with normal left ventricular mass index（LVMI） were studied in group A, 35 patients with increased LVMI in group B, and 24 healthy subjects served as control group. Standard 2D Doppler, mitral annulus inflow and tissue Doppler imaging were used for all measurements. Tei index and modified Tei index were calculated according to respective formula. Results LVEF in three groups were at the same level. Although myocardial systolic peak rate（Sm） by tissue Doppler imaging （TDI） had no significant difference among three groups, it was much higher in group B than in control group. Conclusions Modified Tei index is impaired in hypertensives before ventricular hypertrophy develops and impairment is more prominent in left ventricular hypertrophy. Modified Tei index is gaining importance as a complementary parameter to standard Doppler or in cases where standard Doppler has its limitations.