超声心动图评价高龄高血压患者左心室收缩与舒张功能

Assessment of left ventricular systolic and diastolic function by echocardiography in patients of advanced age with essential hypertension

目的探讨超声心动图各指标评估高龄老年高血压患者左心室不同构型的收缩与舒张功能的临床价值。方法将高龄老年原发性高血压患者153例,按Ganau法分为4组:正常构型组(47例)、向心性重构型组(35例)、向心性肥厚型组(33例)和离心性肥厚型组(38例);另选无心肺疾病的患者65例为正常对照组。超声心动图测量舒张末期室间隔厚度(IVS)、左心室后壁厚度(LVPW)、左心室内径(LVEDD)、二尖瓣血流频谱图舒张早期与晚期血流峰值比(E/A)、LVEF及Tei指数。结果正常对照组及以上4组E/A均<1;离心性肥厚型组LVEF明显降低(P<0.05),正常构型组、向心性重构型组、向心性肥厚型组比较无显著差异;以上4组Tei指数与正常对照组比较差异有显著性意义(P<0.05),但4组间比较无显著差异,Tei指数和E/A无相关性,Tei指数和LVEF呈负相关(r为-0.594,P<0.001)。结论Tei指数较E/A及LVEF更能全面评价高龄老年高血压患者心脏的收缩和舒张功能。

Objective To explore the clinical value of echocardiography in assessment of left ventricular function in patients of advanced age with essential hypertension. Methods 153 patients with essential hypertension were enrolled and 65 normal subjects served as the control group. The conventional Echo-Doppler parameters were assessed,including interventricular septum thickness （IVS）, left ventricular posterior wall thickness（LVPW）, the end diastolic diameter of left ventricle （LVEDD）,E/A ratio,ejection fraction of left ventricle（LVEF） and Tel index. Results E/A was〈1 in both the control group and hypertension groups. The LVEF was significantly reduced in centrifugal hypertrophy group than that of the others（ P〈0.05）. Tei index of all hypertension groups was increased compared with that of the control group（ P〈0.05）. Tel index was not correlated with E/A （ P〉0. 05） and was negatively correlated with LVEF （r=-0.594,P〈0. 001）. Conclusions Tei index is more valuable for estimating left ventricular systolic and diastolic functions than E/A and LVEF do.