应变率成像评价不同血压模式原发性高血压患者左心室功能的研究

Study on the left ventricular function of patients with primary hypertension in different blood pressure models evaluated by strain rate imaging

目的应用应变率成像(SRI)技术评价不同血压模式原发性高血压患者的左心室收缩与舒张功能,为临床诊疗提供依据。方法以40例正常人为对照组,80例原发性高血压患者为观察组,利用SRI技术获取各组左心室收缩期、舒张早期、舒张晚期的平均峰值应变率(mSRs、mSRe、mSRa)及收缩期平均峰值应变(mεs);观察组再根据24h动态血压监测(ABPM)结果将分为杓型组(n=43)与非杓型组(n=37),根据mSRs、mSRe、mSRa及mεs对各组对象的左心室收缩功能与舒张功能进行评价,并作组间比较。结果观察组mSRs、mSRe、mSRa、mεs等指标均低于对照组,且非杓型组mSRs、mSRe、mSRa、mεs等指标均低于杓型组(P<0.05)。结论 SRI技术可以准确而敏感地检测原发性高血压患者左心室收缩和舒张功能的异常变化,不同血压模式的原发性高血压患者左心室心肌应变率及左心室整体功能均较正常人明显减低,且非杓型原发性高血压患者的左心室心肌应变率较杓型原发性高血压患者减低更为明显,其左心室收缩与舒张功能的受损程度较杓型原发性高血压患者更为严重。

Objective To evaluate the left ventricular systolic and diastolic function of patients with primary hypertension in different blood pressure models by applying strain rate imaging （SRI）,and provide the basis for clinical diagnosis and treatment. Methods 40 cases of normal people were selected as the control group,80 patients with primary hypertension were selected as the observation group,mean peak strain rate of left ventricular systole,early diastole, late di- astole （mSRs,mSRe,mSRa） and mean peak strain of systole （mes） were gained by SRI technique;the observation group was divided into the dipper group （n=43） and non-dipper group （n=37） according to results of ambulatory blood pres- sure monitoring （ABPM） in 24 h,and the left ventricular systolic and diastolic function of each group were evaluated by mSRs,mSRe,mSRa and mes,the results of groups were compared. Results The mSRs,mSRe,mSRa,mes of the observa- tion group were lower than that in the control group,and the mSRs,mSRe,mSRa,mes of non-dipper group were lower than that in the dipper group （P〈0.05）. Conclusion SRI technique can accurately and sensitively detect the abnormal changes of left ventricular systolic and diastolic function of patients with primary hypertension, left ventricular myocar- dial strain rate and global function of left ventricular in different patterns of blood pressure in patients with primary hypertension are significantly lower than normal people,the left ventricular myocardial strain rate of non-dipper in patients with hypertensive were significantly reduced compared to dipper of them,their damaged degree of left ventric- ular systolic and diastolic function is more serious than that in dipper of patients with primary hypertensive.