高血压左室向心性肥厚时超声背向散射变化的研究

A Study of the changes of ultrasonic backscatter parameters in left ventricular concentic hypertrophy of hypertension

目的通过对高血压左室向心性肥厚时左室心肌超声背向散射的研究,探讨超声背向散射技术能否用来评价高血压左室心肌重构的程度。方法正常对照组(CON)31例,利用二维心脏超声测量高血压患者左室几何形态参数,依据相对室壁厚度(RWT)和心肌重量指数(LVMI)将筛选出高血压左室向心性肥厚(CON)28例;并用超声背向散射技术测量左室心肌不同切面的声学密度的变化。结果左室向心性肥厚组IVSL、PWL(胸骨旁长轴切面间隔后壁)及IVSA(四腔切面室间隔)、LWA(四腔切面侧壁)的IB(标化的平均声学密度)高于正常对照组(P<0.05);左室向心性肥厚组IVSL的IB与LVMI呈正相关(r=0.43,P<0.05);两组间背向散射积分周期变异幅度(CVIB)均无显著差异;两组跨壁背向散射积分(TGIB)及跨壁心动周期变化的背向散射积分(TGCVIB)较正常无显著差异。结论心肌声学密度变化较敏感的反映高血压左室心肌重构的程度。

Objectives This study was undertaken to investigate the changes of left ventricular function and ultrasonic backscatter parameters in left ventricular concentic hypertrophy of hypertension and to determine whether those changes reflect the degree of the hypertensive left remodeling.Methods There were 28 patients of CCH and 31 healthy volunteers involved in the this study.Left ventricular geomtry and cardial function were studied by using two-diemensional echocardial-graphy.According to relative wall thickness and left ventricular mass index,CCH was selected.and the parameters of ultrasonicmyocardial backscatter were measured.Results 1.In CCH subgroup IB% was higher in long axis view.2.In group CCH,IB% of IVS LAX was relative to LVMI（r=0.71,P0.001;r=0.43,P0.05（5.CVIB had no different in any groups.3.TGIB and TGCVIB had no difference between CON and CCH groups.Conclusions The changes on myocardial acoustic ensity were accordant with that of super-micro-constructure of left ventricular remodeling,so the methd could be used to reflect the degree of left ventricular remodeling.