MRI评估高血压左心室肥厚的临床意义

Clinical Significance of MRI in Evaluating Left Ventricular Hypertrophy in Hypertension

目的研究磁共振(MRI)在评估高血压(EH)左心室肥厚(LVH)中的临床价值。方法以本院2017年12月至2018年12月期间收治的200例EH患者纳为研究对象,根据其左心室室壁厚度分为EH伴LVH组(n=77)与单纯EH组(n=123),并将同期于医院进行健康体检的100例健康者纳为健康对照组,三组均进行MRI检查,比较三组左心室参数值,分析MRI在EH伴LVM中的应用效果。结果单纯EH组及EH伴LVH组的舒张末期容积(EDV)及最高射血率(PER)值均显著高于对照组(P<0.05),EH伴LVH组左室收缩末期容积(ESV)水平显著高于对照组与单纯EH组(P<0.05),单纯EH组及EH伴LVH组每搏输出量(SV)、高峰射血时间(TPER)及射血分数(EF)水平均显著高于对照组(P<0.05),且EH伴左LVH组SV、TPER及EF水平显著高于单纯EH组(P<0.05),三组间EDV、ESV、SV、PER、TPER及EF水平差异显著(P<0.05);单纯EH组与EH伴LVH组高峰充盈率(PFR)显著低于对照组,高峰充盈时间(TPFR)显著长于对照组(P<0.05),且EH伴LVH组患者PFR值显著低于单纯EH组,TPFR值显著长于单纯EH组(P<0.05),三组间PFR及TPFR水平差异显著(P<0.05);单纯EH组及EH伴LVH组患者心肌质量显著高于对照组(P<0.05),且EH伴LVH组心肌质量显著高于单纯EH组(P<0.05),三组间差异显著(P<0.05)。结论MRI可有效提示EH伴EVM患者左心室功能及形态结构特征,反映患者左心室功能障碍,为临床掌握患者病情、制定治疗计划提供参考。

Objective To study the clinical value of magnetic resonance imaging(MRI)in the evaluation of left ventricular hypertrophy(LVH)in essential hypertension(EH).Methods 200 patients with EH admitted to the hospital from December 2017 to December 2018 were included in the study.Patients were divided into an EH-LVH group(n=77)and an EH group only(n=123)according to their left ventricular wall thickness.Another 100 healthy people in the hospital for physical examination in the same period were included in a healthy control group.All three groups were given an MRI.The cardiac parameter values were compared among the three groups,and the application effects of MRI in EH with LVM were analyzed.Results The end-diastolic volume(EDV)and peak ejection rate(PER)in the simple EH group and EH-LVH group were significantly higher than those in the control group(P<0.05).The left ventricular end-systolic volume(ESV)level in EH with the LVH group was significantly higher than that in the control group and simple EH group(P<0.05).The stroke volume(SV),peak ejection time(TPER),and ejection fraction(EF)in simple EH group and EH with LVH group were significantly higher than those in the control group(P<0.05),and the levels of SV,TPER,and EF in EH with LVH group were significantly higher than those in simple EH group(P<0.05).There were significant differences in the levels of EDV,ESV,SV,PER,TPER,and EF among the three groups(P<0.05).The peak filling rate(PFR)in the simple EH group and EH with the LVH group was significantly lower than that in the control group.The peak filling time(TPFR)was significantly longer than that in the control group(P<0.05),and the PFR value of patients in EH with LVH group was significantly lower than that in the simple EH group,and the TPFR value was significantly longer than that in EH group(P<0.05),and there were significant differences among the three groups in the PFR value and TPFR level(P<0.05).The myocardial mass in the simple EH group and EH with LVH group was significantly higher than that in the control group(P<0.05),and the myocardial mass in EH with LVH group was significantly higher than that in the simple EH group(P<0.05),and the difference among the three groups was significant(P<0.05).Conclusion MRI can effectively explain the left ventricular function and morphological characteristics of EH patients with EVM,reflecting the left ventricular dysfunction.It provides a reference for the clinical understanding of patients’condition and the development of the treatment regimen.