高原地区正常成人心脏彩超组织多普勒的观察

Observation of cardiac tissue by Doppler ultrasonography in healthy adults at high altitude

目的分析海拔2808-5012m高原铁路职工左室舒张功能的组织多普勒变化。方法运用组织多普勒技术（TDI）检测二尖瓣环运动频谱Ea、Aa、Ea／Aa及脉冲多普勒检测二尖瓣峰值流速E、A、E／A。结果各指标尤其Ea（≤8．5cm／s）、Aa（≤8cm／s）、Ea／Aa（≤1）、E／A（≤1）者检出率除Aa外汉族均高于藏族（均P〈0．01），除Aa女性高于男性（P〈0．01）外均男性高于女性（P〈0．05或P〈0．01），并随年龄组、高原暴露年限组的上升而阶梯性显著增高（均P〈0．01）；民族、性别、年龄、暴露年限、体重与6项指标以及指标自身间的偏相关分析：年龄与Ea、Ea／Aa中度相关（r〉0．3，P〈0．01），其他为轻度相关或无相关，性别与Ea、Aa、Ea／Aa均无相关，与E、A弱相关，Ea、Aa、Ea／Aa间的相关系数显著大于E、A、E／A间的相关系数。结论高原地区心脏彩超无创分析左心舒张功能有较高异常检出率；组织多普勒的指标明显优于脉冲多普勒检测二尖瓣峰值流速。指标且不受前负荷、性别等其他因素影响，最优指标为Ea≤8．5cm／s及Ea／Aa≤1。

Objective To analyse the changes of left ventricular diastolic function of railway worker at altitude （2808 --5012） m plateau by tissue Doppler Imaging（TDI）. Methods To detect the mitral annulus motion spectrum Ea, Aa, Ea/Aa by TDI and detect the peak mitral flow velocity by pulse Doppler E, A, E/A. Results Indicators in parti- cular Ea（≤8.5 cm/s）, Aa（ ≤8 cm/s）, Ea/Aa（ ≤ 1 ）, E/A （≤ 1 ） detection rates among Aa, Han was higher than Ti- betan（ P〈0.01 ）, except for Aa women than men（P〈0.01） of males than females（ P〈0.05 or P〈0.01 ）, and along with the age group rising ladder, high altitude exposure age group increased significantly（ average P〈0.01 ） ;Expo- sure age,ethnicity,gender,age,weight for 6 indicators and indexes its own partial correlation analysis：Age was de- gree in related winth Ea, Ea/Aa （r〉0.3, P〈0.01 ）, other mildly related or non--related, Gender were not related winth Ea,Aa, Ea/Aa, and weak related winth E.A. The correlation coefficient between Ea, Aa, Ea/Aa significant correlation coefficient was greater than E,A, E/A. Conclusion Cardiac non--invasive analysis of color Doppler ul- trasound in plateau area of left ventricular diastolic function has a high detection rate of exceptions;Tissue Doppler index is significantly better than pulse Doppler detection of peak mitral flow velocity. Index does not preload, gender and other factors,Optimal index for Ea ≤ 8.5 cm/s and Ea/Aa ≤ 1.