高血压患者左房构型超声标化指标与舒张功能关系的研究

Body surface area measurement for estimation of the left ventricular geometry and diastolic function in hypertensive patients

目的:探讨高血压患者左房构型超声标化指标与舒张功能的关系。方法:选择20例正常成人,40例高血压患者(Ⅰ级舒张功能障碍及Ⅱ级舒张功能障碍各20例)。心电触发二维切面测量左房最大内径(LAD)和容积(LAV),用体表面积标化出左房内径指数(LADi)和容积指数(LAVi)。脉冲多普勒测量二尖瓣血流频谱E峰、A峰。组织多普勒测量左室侧壁二尖瓣环运动频谱e及a,计算E/A、e/a及E/e比值。观察各组各项指标的变化以及左房构型指标与舒张功能的关系。结果:高血压患者左房增大,LAV、LADi、LAVi在高血压A、B两组之间差异有显著意义(P<0.01),LAD在高血压A、B组之间的差异无显著意义(P>0.05);高血压组左房构型指标LADi、LAV与E/e比值中度相关,LAVi与E/e比值强相关。结论:按体表面积标化的LADi、LAVi,特别是LAVi,能够更准确地反映高血压患者左室舒张功能障碍。

Objective： To estimate the left atrial geometry and left ventricul ar diastolic function in hypertensive patients by measurement of the body surface area. Methods：Twenty healthy adults and forty hypertensive patients（ Left ventricular diastolic dysfunction at phase I or II ,n =20 for each） underwent echocardiography. The diameter and volume of the left atrium（ LAD and LAV ） were measured at the end-systolic phase of the left ventricle by ECG gating. The indices of the diameter and volume in relation to body surface area（ LADi and LAVi） were calculated. Left ventrieular diastolic function and geometry were assessed by pulsed-wave Doppler examination of mitral and Doppler tissue imaging of the mitral annulus and the ratio of E/e. Results ： The size and index for LAD, LAV, LADi and LAVi were enlarged in hypertens!ve group compared to the con- trol group（P 〈0.01 ）. The differences were significant in LAV,LADi and LAVi between Group A and Group B （ P 〈 0.01 ） in hypertensive patients,yet no significant differences were seen in LAD between Group A and Group B （ P 〉 0.05 ）. Moderate linear correlation was found between the left atrial size LADi and LAV and the ratio of E/e, and LAVi was strongly correlated with the ratio of E/e. Conclusion： Determination of LADi and LAVi by measurement of the body surface area, particularly LA- Vi, may exactly estimate the left ventricul ar diastolic function in patients with hypertension.