背向散射积分技术评价原发性高血压心肌损害的临床应用研究

Study of Integrated Ultrasonic Backscatter on the Evaluation of Myocardial Injury in Patients with Primary Hypertension

目的应用背向散射积分技术评价原发性高血压患者心肌损害程度。方法原发性高血压患者67例,分为两组,NLVH组(高血压非心肌肥厚组)30例:左室心肌重量指数(LVM I)<125 g/m2(男),<120 g/m2(女);LVH组(高血压心肌肥厚组)37例:LVM I≥125 g/m2(男),≥120 g/m2(女)。选择门诊体检正常成人28例为对照组。用二维、M型超声检测对照组和高血压组的室间隔、左室后壁舒张末期厚度、左室心肌重量(LVM)及LVM I;再用背向散射积分技术检测上述3组室间隔、左室后壁的背向散射积分参数即平均背向散射积分(AⅡ)、标化背向散射积分值(AⅡ%,室间隔与左心腔的AⅡ的比值)及背向散射积分心动周期变化幅度(PPI)。结果LVH组室间隔、左室后壁的AⅡ、AⅡ%分别高于NLVH组及对照组(P<0.05)。LVH组室间隔、左室后壁的PPI测值分别低于NLVH组及对照组(P<0.05)。结论背向散射积分技术可作为评价原发性高血压患者心肌损害及其程度的重要参考指标。

Objective To assess the severity of myocardial injury in patients with primary hypertension （PH） by ultrasonic integrated backscatter. Methods 67 patients were divided into non-left ventricular hypertrophy （NLVH） group and left ventrieular hypertrophy （LVH） group,28 healthy adults were selected as control group. The left ventrieular mass index （LVMI） in the NLVH group was lower than 125 g/m^2 in male and 120 g/m^2 in female,while the LVMI in the LVH group was higher than 12.5 g/m^2 in male and 120 g/m^2 in female. The thickness of interventrieular septum and left ventricular posterior wall at end diastolic （IVSd and LVPWd） ,left ventricular mass （LVM） and left ventricular mass index （LVMI） in the three groups were measured by M-moede and Two-dimensional echocardiography respectively. The parameters of average image intensity （AII） ,normalized AⅡ （AⅡ% ,the AⅡ ratio of IVS and LVPW） and peak to peak intensity （PPI）in IVS,LVPW of three groups were measured by ultrasonic integrated back.scaRer. Results The AII and AⅡ% of IVS and LVPW in group LVH were higher than those of group NLVH and the normal group （ P 〈0.05）. The PPI of VS and LVPW in group LVH was lower than that of group NLVH and the normal group （P 〈0. 05 ）. Conclusion Integrated backseatter can he used as referential index to assess severity of myocardial injury in the patients with primary hypertension and offered high application value to the clinical.