超声心动图综合参数在高血压患者左心室舒张功能评估中的应用

The application of comprehensive echocardiographic parameters in assessment of left ventricular diastolic function in patients with hypertension

目的:采用超声心动图的综合参数检测高血压患者左心室舒张功能,探讨其临床评估价值。方法:选择60例高血压病患者将其纳入高血压组,高血压组患者中30例无左心室肥厚,30例存在左心室肥厚;同期选取60名健康体检者为健康对照组。对两组受试者常规进行M型、彩色及多普勒超声心动图检查与组织多普勒成像(TDI),比较高血压组与健康对照组超声心动图综合参数。结果:高血压组与健康对照组相比舒张期室间隔厚度(IVSd)、舒张期左心室后壁厚度(LVPWd)、左心室重量(LVMI)、左房内径(LAD)和左心室内径(LVD)明显增大;高血压组的心肌等容收缩期峰值速度(s′)、心肌舒张早期速度(e′)、二尖瓣舒张早期最大流速(E峰)和左心室舒张末压(LVEDP)明显增大,瓣环最大运动速度(a′)、二尖瓣舒张末期最大流速(A峰)明显减小;与非左心室肥厚相比,左心室肥厚的e′、E和LVEDP明显增大,a′、A明显减小,差异均具有显著统计学意义(t=-4.39,t=-4.39,t=5.47,t=-8.02,t=6.20,t==18.95,t=16.12;P<0.01)。结论:超声心动图综合参数可以评价高血压患者左心室舒张功能损失程度,并可成为是否存在左心室肥厚的评判标准,而组织多普勒成像技术也可作为评价心室舒张功能的一项新手段。

Objective： To discuss the clinical assessment value of comprehensive echocardiographic parameters in detecting the left ventricular diastolic function in patients with hypertension. Methods： 60 hypertensive patients（30 cases without left ventricular hypertrophy（non-LVH）, 30 cases with left ventricular hypertrophy（LVH） were divided into hypertension group, and 60 healthy subjects were in control group. All of the subjects were underwent M type, color ultrasound and tissue Doppler imaging（TDI）. And to compare their comprehensive echocardiographic parameters. Results： Compared with the healthy control group, the IVSd, LVPWd, LVMI, LAD and LVD of hypertension group were significantly enlargement; the s＇, e＇, E peak and LVEDP of hypertension group also significantly increased, while a＇ and A peak were significantly reduced; compared with non-LVH, e＇, E peak and LVEDP of LVH group were significantly increased, and a＇ and A peak were significantly reduced, and these differences were statistically significant（t=-4.39, t=-4.39, t=5.47, t=-8.02, t=6.20, t=18.95, t=16.12; P〈0.01）. Conclusion： The comprehensive echocardiographic parameters can evaluate the extent of damage for left ventricular diastolic function of patients with hypertension, and they can be as the assessment standard of left ventricular hypertrophy. In clinical practice, TDI can be used as a new means in the evaluation of ventricular diastolic function.