多普勒Tei指数评价左室肥厚患者左室整体功能的价值

Value of Tei Index for Estimating Left Ventricular Function in Patients with Left Ventricular Hypertrophy

目的探讨多普勒Tei指数评价左室肥厚患者左室整体功能的临床应用价值。方法40例左室肥厚患者分为2组:肥厚型心肌病组(A组)20例,高血压左室肥厚组(B组)20例;另选30例健康体检者为正常对照组(C组)。应用多普勒超声测量二尖瓣及主动脉瓣血流频谱,计算左室Tei指数;测量并记录二尖瓣口舒张早期血流速度E峰和舒张晚期血流速度A峰之比(E/A)。M型超声测量并计录左室射血分数(EF)、左室舒张末径(LVDd)、左室收缩末径(LVDs)、室间隔舒张末期厚度(IVST),左室后壁厚度(LVPWT)。并分析Tei指数与左室肥厚患者IVST的相关性。结果A、B、C 3组左室Tei指数分别为0.70±0.27、0.50±0.12、0.36±0.07,A、B 2组左室Tei指数均较C组明显升高(P均<0.01),A组左室Tei指数明显高于B组(P<0.05)。A、B、C 3组IVST值分别为(20.4±4.0)(、12.4±0.8)(、8.7±1.2)mm,B、C 2组IVST均明显低于A组(P<0.05,P<0.01),B组IVST明显高于C组(P<0.05);左室肥厚患者A、B 2组Tei指数与IVST均呈正相关(r=0.42、0.37,P均<0.05);A、B、C 3组LVDd值分别为(42.7±6.9)(、48.3±4.0)、(46.7±2.9)mm,A、C 2组LVDd均明显低于B组(P均<0.05);A、B、C 3组EF值分别为68.0±7.1、66.7±6.3、65.3±6.7,3组间EF比较差异均无统计学意义(P均>0.05);A、B、C 3组E/A比值分别为1.72±0.37、0.80±0.27、1.28±0.30,B、C 2组E/A均明显低于A组(P均<0.05)。结论多普勒Tei指数可以评价肥厚型心肌病及高血压左室肥厚患者左室整体功能,并且与左室肥厚患者IVST呈正相关。

Objective To explore the value of Tel index for estimating left ventricular function in patients with left ventricular hypertrophy. Methods Forty patients with left ventricular hypertrophy divided into 2 groups. Twenty patients with Hypertrophic cardiomyopathy were studied in group A, 20 patients with hypertensive heart disease in group B, and 30 healthy subjects was served as control group or group C. Tel index. E/A.EF. ]VST. LVDd of left ventricule were measured with Doppler or M-mode ultrasound in all subjects. Analysis of the correction between Tel index and IVST of groups A and B was conducted. Results The left ventricular Tel index of the three groups were 0. 70±0. 27,0. 50±0. 12,0.36±0.07 respectively, and groups A and B showed significantly higher than group C （all P〈0.01）, group A showed significantly higher than group B（P〈0.05）. IVST were （20.4±4.0）mm, （12.4±0.8）mm, （8.7±1.2）mm respectively, groups B and C showed significantly lower than group A （P〈0.05, P〈0.01）, group B showed significantly highter than group C （P〈0.05）. Left ventricular Tel index and IVST was a positive correlation （r=0. 42,0. 37, all P〈0.05） in patients with left ventricular hypertrophy.LVDd were（42.7±6.9）mm, （48.3±4.0）mm, （46.7±2.9）mm respectively,group A and C was significantly lower than group B （all P〈0.05）. EF were 68.0±7. 1,66.7±6.3,65.3±6.7 respectively. There was no significant difference of the EF among three groups（all P〉0.05）. E/A ratio were 1.72± 0.37,0.80 ± 0.27,1.28 ± 0. 30 respectively, group B and C was significantly lower than group A （all P〈0.05）. Conclusion Tei index can evaluate left ventricular function of hypertrophic cardiomyopathy and hypertension, and be positively correlated with IVST.