心肌声学密度定量分析检测高血压心肌纤维化

Evaluation of Hypertensive Myocardial Fibrosis By Quantitative Myocardial Acoustic Densitometry

目的观察原发性高血压患者心肌声学密度和血清Ⅲ型前胶原末端肽(PⅢNP)含量的变化情况,以评估心肌声学密度定量分析技术检测高血压心肌纤维化的临床价值。方法入选原发性高血压患者75例(高血压组),另选健康体检者75例为对照组。应用超声心动图测量声学密度各项值,采用放免法测定PⅢNP的浓度。结果高血压组的声学强度(CAI)显著高于健康对照组(P<0·01),而高血压组的背向散射积分周期变化值(CVIB)(室间隔6·07±0·85,左室后壁7·00±1·15)显著低于健康对照组(室间隔8·60±3·12,左室后壁11·85±3·06,P<0·05);高血压组血清PⅢNP含量(109·9±7·5)μg/L显著高于健康对照组[(43·9±5·9)μg/L,P<0·01];血清PⅢNP与室间隔和左室后壁声学强度呈显著正相关(P<0·01),与室间隔和左室后壁CVIB呈显著负相关(P<0.01)。结论心肌声学密度定量分析技术是检测高血压心肌纤维化的一项可靠技术。

Objective To evaluate the clinical value of quantitative myocardial acoustic densitometry in myocardial fibrosis in relative to the alteration in serum procollagen type Ⅲ aminoterminal propeptide（ P Ⅲ NP） concentration in hypertensive patients. Methods Seventy-five consecutive hypertensive patients were recruited with 75 normal persons served as healthy controls. The indexes of acoustic densitometry were evaluated by echocardiography and the concentrations of the serum Pill NP peptide by radioimmunoassay. Results Calibrated acoustic intensity in septal（ CAI1 ） and posterior wall （ CAI2 ） in hypertension group （ 0. 88 ± 0. 06, 0. 73 ± 0. 06 ） were greater than that in healthy control group （0. 66±0. 19, 0. 54±0. 06） （P〈0. 01）. Cyclic variation of integrated backscatter in septal（ CVIB1 ） and posterior wall （ CVIB2 ） in hypertension group （ 6.1 ± 0. 8, 7. 0 ± 1.1 dB） were lower than that in healthy control group （8. 6±3.1, 11.8±3. 1 dB） （P〈0.05）. The concentration of P Ⅲ NP in hypertension group（109.9±7.5 μg/L） was greater than that in healthy control group（43.9±5.9 μg/L） （P〈 0. 01 ）, which was positively related with CAI1, CAI2（ P〈0. 01 ）, and inversely related with CVIB1, CVIB2（P〈 0. 01 ）. Conclusion The quantitative myocardial acoustic densitometry is a reliable technique for detecting myocardial fibrosis and may be potentially used for evaluation of severity of myocardial fibrosis.