心脏磁共振评价代谢综合征对高血压患者心脏功能影响的研究

CMR evaluating the impacts of metabolic syndrome on cardiac function in patients with hypertension

目的探讨磁共振成像技术在评价代谢综合征（MS）对高血压患者左心室功能影响中的临床应用价值。方法对高血压代谢综合征（HMS）患者22例、原发性高血压（EH）患者19例和22名健康志愿者（对照组），应用1．5T超导型磁共振扫描仪（Sonata，Siemens），体部相控阵及表面线圈，胸前导联心电门控，采集左心室长轴两腔位、四腔位、三腔位及短轴位动态图像，采用TttrboFlash2D电影序列行左室短轴电影成像，用argus软件massanalysis分别描记左窒心内、外膜界面，自动画出左室容积-时间变化曲线，测得左心室功能参数，并对健康志愿者组与患者组左心室功能数据结果进行比较。结果健康对照组、高血压组、高血压代谢综合征组比较差异均有统计学意义（P〈0．05），如射血分数（EF）：左室高峰射血率（PER）（EDV／s）三组分别为71．60±7．82、65．88＋10．28和58．28±8．46；高峰射血时间（TPER）（ms）三组分别为493．77±138．41、452．30±117．54和319．55±80．59；高峰充盈率（PFR）（EDWs）三组分别为477．03±51．48、443．51±112．43和394．32±133．35；高峰充盈时间（TPFR）（ms）三组分别为67．53±11.73、183．17±23．55和318．65±19．27。结论HMS和EH均可引起左心室功能的改变，代谢功能异常可进一步加重此改变。磁共振成像可准确测定HMS、EH患者左室心功能参数，重复性好。

Objective To study the evaluation value of Magnetic resonance imaging in left ventriculax function in hypertensive patients with metabolic syndrome （metabolic syndrome, MS）. Methods 22 cases of metabolic syndrome of hypertension （HMS）, 19 cases of essential hypertension （EH） and 22 healthy volunteers （control group） were enxolled, the 1.5 T superconducting magnetic resonance scanner （Sonata, Siemens）, body and the department of phased array surface coil, precordial ECG-gated, collecting two chamber spaces left ventricular long axis, four-chamber position, three-chamber and short axis digital motion graphics, using Turbo fast steady-state precession acquisition （FIESTA） 2D sequence line left ventricular clne imaging, with argus software, mass analysis of left ventricular heart tracings, respectively, the outer membrane interface, automatic draw left ventricular volume-time curves, the measured parameters of left ventricular function, and normal volunteers and patients groups group of left ventricular function data were compared. Results In normal control group, hypertension and high blood pressure metabolic syndrome group, the left ventricular peak ejection rate （PER） （71.60± 7.82, 65.88±10.28, 58.28±8.46）, peak ejection time （TPER） （493.77±138.41, 452.30±117.54, 319.55± 80.59）, peak filling rate （PFR）（477.03±51.48, 443.51±112.43, 394.32±133.35）, and peak filling time （TPFR） （67.53±11.73, 183.17±23.55, 318.65±19.27） were statistically difference （P〈0.05）. Conclusion HMS and EH can cause changes in left ventricular function, and metabolic dysfunction may further aggravate this change; magnetic resonance imaging can accurately determine the film HMS, EH patients with left ventricular heart function parameters, and good reproducibility.