彩超诊断高血压病左心室构型与功能改变的临床研究

Clinical study on the structure of left ventricle and the change of function in diagnosing hypertension with color Doppler ultrasound

目的:研究高血压病患者左心室的不同构型对左心室舒张功能的影响。方法:对高血压病组51例,对照组40例进行超声心动图检查,测定左心室重量(LVW)和室壁相对厚度(RWT);以脉冲多普勒取样容积置于二尖瓣下测定左室流入道的E峰值和A峰值;以彩色多普勒超声检测有无二尖瓣或主动脉瓣返流以及其程度。根据LVW与RWT分析高血压病的左心室不同构型判断左心室舒张期顺应性的意义。结果:高血压病组60.78%的患者左心室有不同程度的肥厚,64.7%的患者E/A<1,而在离心性肥厚组中有35.29%患者E/A>1,说明当左心室壁松弛性减退和僵硬度增加时,二尖瓣血流频谱可表现为"假性正常化"。结论:高血压病患者早期出现舒张功能障碍主要与压力负荷过重有关,晚期既与压力负荷过重,又与容量负荷过重有关。

Objective： To explore the influence of different structures of left ventricle on its diastolic function of patients with hypertension.Methods： 51 cases with hypertension and 40 cases of control group were examined by ultrasonic cardiogram to measure left ventricular weight（LVW） and relative wall thickness（RWT）;puting sample volume below mitral valve with pulse Doppler to measure E peak value and A peak value of left ventricular inflowtract;examining with color Doppler if there was mitral valve or aortic regurgitation and its extent.Analyze different structures of left ventricle of hypertension according to LVW and RWT and judged the significance of left ventricle diastolic compliance.Results： 60.78% of the patients with hypertension suffered from different levels of left ventricular hypertrophy.The E/A of 64.7% of the patients was below one,but the E/A of 35.29% of the patients was above one in eccentric hypertrophy group,which indicated that when left ventricular wall relaxation decreases and stiffness increases,mitral valve flow spectrum could be ＂pseudonormal＂.Conclusion： For patients with hypertension,in early period,diastolic dysfunction is chiefly related with pressure overload;in later period,it is related with both pressure overload and volume overload.