组织多普勒Tei指数评价抗病毒治疗对艾滋病患者左心室功能的影响

Assessment of left ventricular function in AIDS patients with & without high active antiretroviral therapy by tissue Doppler imaging Tei index technology

目的:利用组织多普勒超声心动图技术测量Tei指数评价高效抗逆转录病毒治疗(HARRT)对艾滋病患者左心室功能的影响。方法:选取198例艾滋病患者,按病程进展分为无症状的人类免疫缺陷病毒(HIV)携带者100例(Ⅰ组)和发生多种并发症的获得性免疫缺陷综合征(AIDS)患者98例(II组);并按是否接受HAART分为Ⅰa、Ⅰb组和Ⅱa、Ⅱb组;另选取50例心血管无异常发现的健康志愿者作为正常对照组(NC组)。对所有对象行超声心动图检查,在组织多普勒成像(TDI)模式下,分别获得二尖瓣环水平左室侧壁位点的组织多普勒频谱,测量并记录a线,b线及计算相应的Tei指数,并对相关指标作对比分析。结果:①与对照组比较,Ⅰ组和Ⅱ组患者a、(a-b)及Tei指数明显升高,b明显减小,差异具有统计学意义(P<0.01或P<0.001);②Ⅰ组内,Ⅰa组与Ⅰb组比较,a、(a-b)、b及Tei指数差异无统计学意义;③Ⅱ组内,Ⅱa组与Ⅱb组比较,a、(a-b)、b及Tei指数差异无统计学意义。结论:HIV感染患者左心室功能相对减低;在一定时间内,高效抗逆转录病毒治疗对左心室整体功能无明显影响。

Objective： To assess left ventricle（LV） function in HIV-seropositive patients with ＆ without highly active antiretroviral therapy（HAART）by tissue Doppler imaging（TDI） Tei index technology.Methods：198 HIV-seropositive patients recruited were classified into two groups according to infection statuses.One group consisted of 100 asymptomatic HIV-carrier patients： 50 patients（Ⅰa group） with HAART and 50 patients without HAART（Ⅰb group）;and the other group consisted of 98 AIDS patients,49 patients（Ⅱa group） with HAART and 49 patients without HAART（Ⅱb group）.Meanwhile,50 healthy volunteers were selected as normal control（NC group）.Parameters related TDI Tei index,including interval a,b,（a-b） and Tei indices were measured respectively in all groups and were analyzed comparatively.Results： ① Compared to normal controls,HIV-carrier patients and AIDS patients all exhibited significantly increased a,（ab） and Tei indices and depressd b（P〈0.01 or P〈0.01）;② In Ⅰ group,compared to Ⅰb group,Ⅰa group patients exhibited no significant variance in a,b,（a-b） and Tei indices（P〉0.05）.（3） In Ⅱ group,compared to Ⅱb group,Ⅱa group patients exhibited no significant variance in a,b,（a-b） and Tei indices（P〉0.05）.Conclusion： LV function in HIV-seropositive patients was,compared to normal controls,depressed;And in a short therapy interval,HAART didn＇t exhibit significant impact on LV global function in HIV-seropositive patients.