心脏彩色多普勒超声在高血压左心室肥大伴左心衰竭诊断中的应用价值

Diagnostic value of color Doppler echocardiography in hypertensive patients with left ventricular hypertrophy and left heart failure

目的探讨心脏彩色多普勒超声在高血压左心室肥大伴左心衰竭诊断中的应用价值。方法选择2015年1月至2017年1月商丘市第四人民医院收治的100例高血压左心室肥大伴左心衰竭患者作为观察组,另选择同期体检健康者100例作为对照组,2组受试者均进行心脏彩色多普勒超声检查,对2组受试者及不同心功能分级患者的心脏彩色多普勒超声检查结果进行比较。结果观察组患者的左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室短轴缩短(LVFS)、左心房内径(LAD)及舒张早期左房室瓣口最大血流速度(E)/舒张早期左房室瓣环最大运动速度(EA)显著大于对照组,左心室射血分数(LVEF)显著低于对照组(P <0. 05)。不同美国纽约心脏病学会(NYHA)分级高血压左心室肥大伴左心衰竭患者的LVEDD、LVESD、LVFS、LAD、E/EA及LVEF比较差异均有统计学意义(P <0. 05)。NYHA分级Ⅱ、Ⅲ级患者的LVEDD、LVESD、LVFS、LAD及E/EA显著大于Ⅰ级患者,LVEF显著低于Ⅰ级患者(P <0. 05)。NYHA分级Ⅲ级患者的LVEDD、LVESD、LVFS、LAD及E/EA显著大于Ⅱ级患者,LVEF显著低于Ⅱ级患者(P <0. 05)。结论心脏彩色多普勒超声能够清晰显示心脏结构,评估心脏功能,对高血压左心室肥大伴左心衰竭的诊断有重要价值。

Objective To investigate the diagnostic value of color Doppler echocardiography in hypertensive patients with left ventricular hypertrophy and left heart failure.Methods A total of 100 hypertensive patients with left ventricular hypertrophy and left heart failure in the Fourth People′s Hospital of Shangqiu City from January 2015 to January 2017 were selected as the observation group,and 100 healthy people were selected as the control group.The patients in the two groups were examined by color Doppler echocardiography.The results of color Doppler echocardiography were compared between the two groups and the patients with different cardiac functional grading.Results The left ventricular end-diastolic dimension （LVEDD）,left ventricular end-systolic dimension （LVESD）,left ventricular fractional shortening （LVFS）,left atrial dimension （LAD） and the maximum velocity of left atrioventricular valve opening during early diastole （E）/the maximal velocity of left atrioventricular annulus during early diastole （EA） in the observation group were significantly higher than those in the control group;and the left ventricular ejection fraction （LVEF） in the observation group was significantly lower than that in the control group （ P 〈0.05）.There were significant differences in the LVEDD,LVESD,LVFS,LAD,E/EA and LVEF among the hypertensive patients with left ventricular hypertrophy and left heart failure with different New York Heart Association （NYHA） grades （ P 〈0.05）.The LVEDD,LVESD,LVFS,LAD and E/EA in the patients with NYHA grade Ⅱ and Ⅲ were significantly higher than those in the patients with NYHA grade I,and the LVEF in the patients with NYHA grade Ⅱ and Ⅲ was significantly lower than that in the patients with NYHA grade Ⅰ （ P 〈0.05）.The LVEDD,LVESD,LVFS,LAD and E/EA in the patients with NYHA grade Ⅲ were significantly higher than those in the patients with NYHA grade Ⅱ,and the LVEF in the patients with NYHA grade Ⅲ was significantly lower than that in the patients with NYHA grade Ⅱ （ P 〈0.05）.Conclusion Color Doppler echocardiography can clearly display the structure of the heart and evaluate the function of the heart.It has important diagnostic value for hypertensive patients with left ventricular hypertrophy and left heart failure.