多普勒超声Tei指数在原发性高血压左心功能评估中的价值

Value of Doppler Ultrasound Tei Index in the Evaluation of Left Ventricular Function for Patients with Essential Hypertension

【目的】探讨多普勒超声心肌综合指数（Tei 指数）在原发性高血压患者左心功能评估中的价值。【方法】选取原发性高血压患者168例，按照 Ganau 分型法分为四组。正常构型44例（A 组）：左心室质量指数（LVMI）及左心室壁相对厚度（RWT ）无异常；向心性重构47例（B 组）：LVMI 正常，RWT 异常；向心型肥厚42例（C 组）：LVMI 及 RWT 均异常；离心型肥厚35例（D 组）：LVMI 异常，RWT 正常。另外选取40例健康体检者为对照组（E 组）。测量并比较各组二尖瓣舒张早期与舒张晚期二尖瓣血流速度比值（E／A 值）、左心室射血分数（LVEF）及左室 Tei 指数。【结果】A 、B 、C 、D 组 E／A 值较 E 组均显著下降（ P ＜0．05）；各组 LVEF 值均在50％以上，D 组最低，显著低于其他各组（ P ＜0．05）；A 、B 、C 、D 组 Tei 指数均显著高于 E 组，且 C 组显著高于 B 组，D 组显著高于 C 组，差异均有统计学意义（ P ＜0．05）。经 Logistic 多因素分析，左室损害程度与 LVEF 呈负相关，与Tei 指数呈正相关。【结论】多普勒超声 Tei 指数能反映原发性高血压患者左心功能受损，是评价左心功能简便、灵敏和准确的指标。

[Objective] To explore the value of Doppler ultrasound Tei index in the evaluation of left ventricular function in hypertensive patients .[Methods] A total of 168 patients with essential hypertension were selected from April 2014 to November 2014 .According to the Ganau points ,they were divided into four groups of A ：normal geometry [left ventricular mass index （LVMI） and relative wall thickness （RWT ） normal ,n = 44] ,B ：con‐centric remodeling （LVMI normal ,RWT abnormal ,n = 47） ,C ：heart hypertrophy （LVMI ＆amp; RWT abnormal ,n= 42） of D ：centrifugal hypertrophy （LVMI abnormal ,RWT normal ,n = 35） .And 40 healthy males were select‐ed as control group .The values of mitral E/A ratio ,LVEF and left ventricular Tei index were calculated and compared .[Results] The patient group had decreased E/A values compared with control group （ P 〈 0 .05） .LVEF values were all above 50% .D was the lowest （ P 〈 0 .05） .Tei index increased in groups A‐D compared with con‐trol group .And there were significant statistical significances （ P 〈 0 .05） .Logistic multivariate analysis revealed that damage extent and LVEF were inversely proportional to Tei index .[Conclusion] Doppler ultrasound Tei index is simple ,sensitive and accurate for evaluating left ventricular function in hypertensive patients .