颈动脉瞬时波强技术评价原发性高血压病患者左室-动脉整体功能的研究

Assessment of ventricular arterial integrated function of patients with essential hypertension using carotid wave intensity analysis

目的探讨瞬时波强(WI)技术评价不同左室构型原发性高血压病患者左室-动脉系统整体功能的临床价值。方法根据Ganau分类法将80例原发性高血压病患者分为左室正常构型组(23例)、向心性重构组(18例)、向心性肥厚组(28例)及离心性肥厚组(11例),同时选取40例健康志愿者作对照组。常规超声心动图测量各组舒张末期室间隔、左室后壁厚度及左室内径,计算左室质量指数和相对室壁厚度,左室射血分数(LVEF)和舒张早期二尖瓣口峰值血流速度与二尖瓣环峰值运动速度比值(E/E’)。于右侧颈总动脉行WI检查,记录各参数值并进行比较。结果除离心性肥厚组外,高血压病其余各组瞬时加速度波强(W1)均较对照组明显升高(P<0.05);高血压病各组瞬时减速度波强(W2)均小于对照组(P<0.05),负向波面积与对照组无明显差异;时间参数方面,除离心性肥厚组心电图R波至第一个正向波波峰时间(R-W1)显著延长,两个正向波之间的时间(W1-W2)明显缩短,与对照组比较差异均有统计学意义(均P<0.01)外,余高血压病各组R-W1及W1-W2与对照组比较差异均无统计学意义。结论 WI技术各指标能简便、准确地综合评价原发性高血压病患者左室-动脉整体功能。

Objective To investigate the clinical value of wave intensity （WI） technique in assessing ventricular arterial function of patients with essential hypertension. Methods Eighty patients were divided into 4 groups according to different geometry of left ventricle （LV）, including 23 cases of normal LV configuration group, 18 cases of concentric remodelling group, 28 cases of concentric hypertrophy, 11 cases of eccentric hypertrophy, and 40 healthy voluteers were enrolled in the control group. Both echocardiography and right common carotid arterial WI technique were done and the results were compared. Data of the systolic and diastolic function （LV quality index, wall thickness, LVEF, E/E＇ ） were recorded. Results Compared to the control group,the W2 was significantly lower in all four hypertension patients groups, while the W1 was higher in three groups except the eccentric hypertrophy group. No significant difference of negative-wave area （NA） was found in hypertension group and control group. The difference of the time intervals between electrocardiographic R-wave and W1, and between the two positive waves in WI curve were found significantly different only in eccentric hypertrophy group. Conclusion WI technique is a novel noninvasive method which could be used in assessing the ventricular arterial function of essential hypertension patients.