Tei指数评价老年高血压病患者左心功能的研究

Study on evaluation of left ventricular function variation of elderly hypertensive patients by Tei index

目的探讨应用Tei指数评价老年高血压病患者左心功能的应用价值。方法对94例老年高血压病患者进行左心室Tei指数的测定。按Ganau分类法分为4种左室构型:正常构型组(Ⅰ组)、向心性重构组(Ⅱ组)、向心性肥厚组(Ⅲ组)、离心性肥厚组(Ⅳ组);超声心动图测量舒张末期室间隔(IVS)、左室后壁厚度(LVPW)、左室舒张末期内经(LVEDD)、左室收缩末期内径(LVESD)、左房内径(LAD)、二尖瓣口血流频谱舒张早期和舒张晚期血流峰值比值(E/A)、左室射血分数(EF)以及左室Tei指数。结果高血压各组和对照组E/A比值均<1,各组间无显著性差异;高血压各组和对照组LVEF均大于>50%,各组间无显著性差异;高血压各组左室Tei指数较对照组显著增大(P<0.05),高血压各组中,Ⅱ组和Ⅰ组,Ⅳ组和Ⅰ、Ⅱ、Ⅲ组左室指数的组间有显著性差异(P均<0.05);对照组中Tei指数与年龄进行相关性分析发现,左室Tei指数与年龄之间无显著性差异(P>0.05)。结论Tei指数能够灵敏地检测出高血压患者早期左心整体功能改变,当老年高血压患者出现左室构型改变时,能够反映其相应左心功能损害,是一种评价左心功能变化准确、无创的方法。

Objective It is to approach the value of Tei index in evaluating left ventricular function variation of elderly hypertensive patients. Methods The left ventricular Tel indexs of 94 cases of elderly hypertensive patients were detected. Four types of configuration of left ventricular were classified by Ganau Classification： normal configuration group （Group I ）, concentric remodeling group （Group Ⅱ ）, concentric hypertrophy group （Group Ⅲ ） and centrifugal hypertrophy group （Group Ⅳ ）. The indexes of end-diastolic ventricular interval （IVS）, left ventricular posterior wall thickness （LVPW）, left ventricular end-diastolic dimension （LVEDD）, left ventricular end-diastolic dimension （LVESD）, left atrial diameter （LAD）, E/ A, ejection fraction （EF） and left ventricular Tel index were detected by uhrasoundeardiogram. Results The values of E/A of the hypertensive groups and the control group were both less than 1, there was no significant difference between them; the values of LVEF of the hypertensive groups and the control group were both higher than 50 % , there was no significant difference between them; the left ventricular Tel indexes were higher in the hypertensive groups than that in the control group （P〈 0.05）, and there was significant difference in left ventricular Tel index among Group Ⅱ and Group Ⅰ , Group Ⅳ and Group Ⅰ , Ⅱ , Ⅲ ; there was no significant correlation between the left ventricular index and the age according to the relevant analysis on them （ P 〉 0.05）. Conclusion The Tei index can be sensitive in determining early left ventricular whole function variation of hypertensive patients, and can reflect different degrees of corresponding left ventricular damages when there is a variation of left ventricular configuration of elderly hypertensive patients, and it is an accurate and noninvasive method for evaluating left ventricular function variation.