超声检测高血压左心室功能常规指标与Tei指数比较研究

Comparat ive study of conventional index with Tei index in ultrasound examination of hypertensive left ventricular function

目的探讨更能早期评价高血压患者左心室收缩及舒张功能的变化的评测指标。方法正常组30例(组1),其中男性10例,女性20例,平均年龄54.5岁;高血压左心室非肥厚组21例(组2),其中男性8例,女性13例,平均年龄54.2岁;左心室肥厚组24例(组3),其中男性12例,女性12例,平均年龄55.8岁。应用M型超声心动描记术测量常规左心室收缩功能指标左心室射血分数(LVEF)和左心室短轴缩短率(LVFS);用多普勒超声心动描记术测量左心室舒张功能指标二尖瓣口舒张早期和晚期血流速度之比(VE/VA);用多普勒组织成像探测舒张功能指标二尖瓣环舒张早期及舒张晚期运动速度之比(Em/Am);用多普勒超声测量等容舒张时间(IRT)、等容收缩时间(ICT)和射血时间(ET),并计算左心室Tei指数。结果组1、组2和组3的LVFS、LVEF均在正常范围,且组2和组3LVFS均高于组1,差异具有统计学意义(P<0.05);组2LVEF大于组1,差异具有显著统计学意义(P<0.01);二尖瓣口的VE/VA和Em/Am都呈现组2和组3均低于组1的趋势,差异具有统计学意义(P<0.05),组2与组3之间VE/VA和Em/Am无统计学差异(P>0.05)。组2和组3左心室Tei指数和IRT均大于组1(P<0.01),组3左心室Tei指数较组2有增大的趋势(P<0.05);与组1相比,组2与组3的ICT均延长(P<0.05)。结论Tei指数能敏感反映高血压左心室功能降低;常规左心室舒张功能指标VE/VA和Em/Am能敏感反映高血压左心室舒张功能低于正常对照组。

Objective To study the assessment index for earlier evaluation of hypertensive left ventricular systolic and diastolic function changes.Methods Thirty normal subjects were enrolled in the control（group1）,male 10,female 20,mean age 54.5 years;21 essential hypertension patients without left ventricular hypertrophy were enrolled in group 2,male 8,female 13,mean age 54.2 years and 24 essential hypertension patients with left ventricular hypertrophy were enrolled in group 3,male 12,female 12,mean age 55.8 years.These 3 groups were studied by echocardiography.The conventional left ventricular systolic function index ejection fraction（LVEF） and left ventricular fraction shortening（LVFS） were measured by M-mode echocardiography;mitral early diastolic and late diastolic velocity ratio of VE/VA were measured by Doppler echocardiography;mitral annulus displacement velocity ratio of Em/ Am were measured by Doppler tissue imaging;isovolumic relaxation time（IRT）,isovolumic contraction time（ICT） and ejection time（ET） were measured by Doppler echocardiography,and left ventricular Tei index was calculated.Results The LVEF and LVFS values were normal in all of the subjects in 3 groups.Compared with group 1,LVFS values in both group 2 and group 3 were higher,with statistical significance difference（P 0.05）,LVEF values in group 2 were higher than group 1,with statistical significance difference（P 〈0.01）.Mitral early diastolic and late diastolic velocity ratio of VE/VA and Doppler tissue imaging of mitral annulus displacement velocity ratio of Em/Am in both group 2 and group 3 were lower than group 1,the difference were showed statistical significance（P 〉0.05）,group 2 and group 3 were no significant difference（P 〉0.05）.In both group 2 and group 3,LV Tei index and IRT were significantly higher than in group 1.LV Tei index in group 3 had the higher tendency than in group 2.Compared with group 1,ICT were higher than in group 2 and group 3.Conclusion The Tei index is sensitive to reflect reduction of left ventricular function in essential hypertension groups.Compared with normal control subjects,conventional cardiac function index VE/VA and Em/Am is sensitive to reflect reduction of left ventricular diastolic function in essential hypertension groups.