斑点追踪显像技术评价不同构型高血压患者左室舒缩功能的研究

Speckle tracking imaging for the evaluation of left ventricular systolic and diastolic function in essentialhypertension patients with different left ventricular geometric patterns

目的应用斑点追踪显像(STI)技术检测高血压患者左心室重构过程中左室舒缩功能的改变。方法选取正常对照组(40例)和高血压患者(60例),按照Ganau分型法将高血压患者分为正常构型组(LVN组)和左室重构组(LVR组),其中LVR组包括向心性重构(13例)、向心性肥厚(7例)和离心性肥厚(10例)。应用STI技术获得左室6个壁基底段、中间段、心尖段的舒张早期峰值应变率(Sre)、舒张晚期峰值应变率(Sra)、收缩期峰值应变(SLs)及应变率(Sr Ls),并计算平均峰值应变及应变率(m SLs、m Sr Ls、m Sr Le、m Sr La及m Sr Le/m Srla)。结果舒张功能:与正常组比较,LVN组及LVR组Sr Le降低,LVR组部分节段Sr La升高,差异有统计学意义(P<0.05);与正常组比较,LVR组m Sr Le,m Sr Le/m Sr La降低,m Sr La升高,差异有统计学意义(P<0.05)。收缩功能:与正常组比较,LVN组及LVR组SLs、m SLs、Sr Ls、及m Sr Ls降低,差异有统计学意义(P<0.05),LVR组SLs、m SLs、Sr Ls及m Sr Ls较LVN组减低,差异有统计学意义(P<0.05)。结论 STI技术能准确地测量高血压病患者舒张期及收缩期左室心肌应变率,对评价高血压患者左室舒缩功能具有重要临床意义。

Objective To evaluate the systolic and diastolic function of left ventricular during left ventricular geometric remodeling by ultrasound speckle tracking imaging（STI） in essential hypertension patients. Methods Sixty patients with essential hypertension and forty healthy subjects were collected. According to Ganau＇ s categories ,60 patients with hyper- tension were divided into normal LV geometric patterns（LVN） group and Left ventricular remodeling（LVR） group. LVR group included 13 concentric remodeling patients, 7 concentric hypertrophy patients, 10 eccentric hypertrophy pa- tients. The peak systolic strain（SLs） ,peak systolic strain rate（SrLs） ,peak early diastolic strain rate（Sre） and peakl late diastolic strain rain（Sra）at middle,basal and apical ventricule were measured,by using STI, then the average of strain （mSLs） and strain rate（ mSrLs, mSrLe, mSrLa and mSrLe/mSrla） in the left ventricular were calculated. Results Dias- tolic function： compared with the control group, SrLe of LVN and LVR was reduced, many parameters of Sra in the LVR group was higher（P 〈 0.05 ） ; Compared with the control group, mSrLe and mSrLe/mSrLa of LVR were reduced, mSrLa was higher（ P 〈 0. 05 ）. Systolic function：Compared with the control group, SLs, mSLs, SrLs and mSrLs of LVN and LVR were reduced （P 〈 0.05 ）, while compared with LVN, SLs, mSLs, SrLs and mSrLs of LVR were reduced （ P 〈 0.05 ）. Conclusion STI can quantify diastolic and systolic strain rate on walls of left ventricular properly, which has great signif- icance in assessment of left ventriculardiastolic and systolic in patients with essential hypertension.