高血压心肌声学密度与血管紧张素Ⅱ和醛固酮的关系

Relationship between myocardial acoustic density and plasma angiotensin Ⅱ and aldosterone concentrations in essential hypertensive patients

目的观察原发性高血压患者心肌声学密度的变化情况,以探讨心肌声学密度检测高血压心肌纤维化的临床价值及其与血浆血管紧张素Ⅱ(AngⅡ)和醛固酮的关系。方法共入选原发性高血压患者75例(高血压组),并设立健康对照组75例。应用超声心动图测量计算心肌声学密度各项值(室间隔和左室后壁矫正的声学强度CAI1、CAI2及背向散射积分周期变化值CVIB1、CVIB2值),用放免法检测血浆AngⅡ和醛固酮浓度。结果(1)高血压组的CAI1、CAI2显著高于健康对照组(P<0.01),而高血压组的CVIB1、CVIB2显著低于健康对照组(P<0.05);(2)高血压组的血浆AngⅡ和醛固酮浓度均显著高于健康对照组(P<0.01);(3)血浆AngⅡ和醛固酮浓度与CAI1、CAI2显著正相关,与CVIB1、CVIB2显著负相关(P<0.01)。结论心肌声学密度定量分析技术可用于评估高血压心肌纤维化的严重程度,并且心肌声学密度与血浆AngⅡ和醛固酮浓度均显著相关。

[Objective] To explore the the clinical value of quantitative myocardial acoustic densitometry in checking hypertensive myocardial fibrosis, and the relationship between the myocardial acoustic density and the plasma angiotensin Ⅱ （Ang Ⅱ ）, as well as the aldosterone concentrations. [Methods] 75 consecutive essential hypertensive patients were chosen as hypertention group, and 75 normal persons were served as healthy control group. The indicatrix of acoustic densitometry which included the calibrated acoustic intensity （CAI） and the cyclic variation of integrated backscatter （CVIB） of interventricular septum and left ventricular posterior wall were evaluated by echocardiography, and the plasma Ang Ⅱ and aldosterone concentrations were measured by radioimmunoassay. [Results] The CAI1 and CAI2 in hypertension group were significantly higher than that in healthy control group （P 〈 0.01）, and CVIB1 and CVIB2 in hypertension group were significantly lower than that in healthy control group （P 〈 0.05）; The plasma Ang Ⅱ and aldosterone concentrations in hypertension group were significantly higher than that in healthy control group （P 〈0.01）; The plasma Ang Ⅱ and aldosterone concentrations were positively related with CAI1 and CAI2 （P 〈0.01）, and inverse related with CVIB1 and CVIB2 （P 〈0.01） [Conclusion] The quantitative myocardial acoustic densitometry can be used for evaluation of the severity degree of hypertensive myocardial fibrisis, and the value of myocardial acoustic density is related with plasma Ang Ⅱ and aldosterone concentrations significantly.