超声心动图检查对高血压合并心房颤动患者心功能的评估价值

Clinical value of echocardiography in evaluation of cardiac function in hypertension patients complicated with atrial fibrillation

目的 探讨超声心动图检查对高血压合并心房颤动（简称房颤）患者心功能的评估价值.方法选取60例高血压合并房颤患者（观察组）,同时选取同期在该院体检的健康者30例（对照组）,分别应用常规二维超声观测左房前后径（LAD）、左室舒张末内径（LVEDD）、左室收缩末期内径（LVESD）、左心室射血分数（LVEF）;应用二尖瓣血流频谱观测E峰、A峰及积分E-VTI、A-VTI,并计算E/A,并计算记录E峰减速时间（DT）;应用肺静脉血流频谱：收缩期速度（S）及积分（S-VTI）、D峰及积分（D-VTI）,记录收缩期反流速度（Ar峰）,并计算S/D值.结果 观察组LAD、LVEDD、LVESD、LAVmax、LAVmin分别为（43.01±2.34）mm、（48.87±4.35）mm、（30.29±4.34）mm、（42.38±3.55）mL、（20.22±2.35）mL显著高于对照组（34.23±2.10）mm、（43.23±4.30）mm、（24.34±4.12）mm、（31.04±3.10）mL、（14.57±2.19）mL,差异有统计学意义（t=17.34、5.82、6.34、14.88、10.99,均P〈0.05）;观察组LVEF、TA-EF分别为（62.03±5.56）%、（58.66±5.45）%均显著小于对照组（59.35±4.45）%、（52.34±4.68）%,差异有统计学意义（t=2.30、10.99,均P〈0.05）.观察组E峰、E-VTI、E/A分别为（91.22±12.10）cm/s、（15.17±3.31）、（2.38±0.55）均显著高于对照组（71.28±12.11）cm/s、（12.21±3.30）、（0.92±0.30）（t=7.37、4.04、13.54,均P〈0.05）;观察组A峰、A-VTI、DT分别为（46.89±5.36）cm/s、（4.23±1.06）、（120.32±12.45）均显著低于对照组的（79.44±6.12）cm/s、（7.85±1.15）、（234.37±13.49）（t=25.89、14.84、39.84,均P〈0.05）.观察组D峰、D-VTI分别为（53.80±5.76）cm/s、（14.20±1.56）均显著高于对照组的（44.54±3.58）cm/s、（11.15±1.55）（t=8.64、6.34,均P〈0.05）;观察组S峰、S-VTI、S/D、Ar分别为（41.21±4.04）cm/s、（11.87±5.37）、（0.78±0.09）、（21.34±3.05）均显著低于对照组的（53.26±4.15）cm/s、（16.28±5.33）、（1.29±0.13）、（38.57±3.89）（t=12.12、3.94、21.75、23.00,均P〈0.05）.结论 超声心动图可以反映高血压合并房颤患者的心功能,评估心肌是否重塑及心房贮存、管道及助力泵功能的受损情况,对临床治疗和预后评估具有重要的临床意义.

Objective To discuss the clinical value of using echocardiography to evaluate cardiac function in hypertension patients complicated with atrial fibrillation.Methods 60 hypertension patients complicated with atrial fibrillation were chosen as the observation group,and meanwhile 30 healthy subjects were chosen as the control group.Conventional two dimensional ultrasound was used to observe left front diameter （LAD）,left ventricular end diastolic diameter （LVEDD）,left ventricular end systolic diameter （LVESD） and left ventricular ejection fraction （LVEF）.And mitral valve flow spectrum was also used to detect A peak and integral E-VTI E peak,A-VTI,and E/A,including the E peak deceleration time （DT）.Pulmonary vein blood flow spectrum was used to detect systolic velocity （S）,integral S-D-VTI,VTI,D peak,integral record systolic flow velocity （peak） Ar,and calculate the S/D value.Results In the observation group, LAD,LVEDD,LVESD,LAVmax and LAVmin were （43.01±2.34）mm,（48.87±4.35）mm,（30.29±4.34）mm,（42.38±3.55）mL and （20.22±2.35）mL, which were significantly higher than those in the control group [（34.23±2.10）mm,（43.23±4.30）mm,（24.34±4.12）mm,（31.04±3.10）mL and （14.57±2.19）mL], the differences were statistically significant （t=17.34,5.82,6.34,14.88 ,10.99,all P〈0.05）.In the observation group, the LVEF and TA-EF were （62.03±5.56）% and （58.66±5.45）%, which were significantly lower than those in the control group [（59.35±4.45）% and （52.34±4.68）%], the differences were statistically significant （t=2.30,10.99,all P〈0.05）.In the observation group, the E peak,E-VTI and E/A were （91.22±12.10）cm/s,（15.17±3.31） and （2.38±0.55） respectively, which were significantly higher than those in the control group [（71.28±12.11）cm/s,（12.21±3.30） and （0.92±0.30）, t=7.37,4.04,13.54,all P〈0.05].In the observation group, A peak,A-VTI and DT were （46.89±5.36）cm/s,（4.23±1.06） and （120.32±12.45）,respectively, which were significantly lower than those in the control group [（79.44±6.12）cm/s,（7.85±1.15） and （234.37±13.49）,t=25.89,14.84 ,39.84,all P〈0.05].In the observation group, D peak and D-VTI were （53.80±5.76）cm/s and （14.20±1.56） respectively, which were significantly higher than those in the control group [（44.54±3.58）cm/s and （11.15±1.55）,t=8.64,6.34,all P〈0.05].In the observation group, Speak,S-VTI,S/D and Ar were （41.21±4.04）cm/s,（11.87±5.37）,（0.78±0.09） and （21.34±3.05） respectively, which were significantly lower than those in the control group [（53.26±4.15）cm/s,（16.28±5.33）,（1.29±0.13） and （38.57±3.89）,t=12.12,3.94,21.75,23.00,all P〈0.05].Conclusion Echocardiography can reflect the cardiac function in hypertension patients with atrial fibrillation.And assessing myocardial remodeling and atrial room to store the damage situation, pipeline and booster pump function all has important clinical significance for clinical treatment and prognosis assessment.