摘要
目的 应用二维及组织多普勒超声 (TDI)技术探讨高血压病患者左心室质量和舒张功能与内分泌因子的关系。方法 61例高血压病患者根据超声心动图测量左室质量指数 (LVMI)分为左室心肌肥厚组(LVH ,3 0例 )和非左室心肌肥厚组 (NLVH ,3 1例 )。 2 0例健康者为对照组。组织多普勒测量二尖瓣环心肌舒张早期峰值运动速度 (e)、晚期峰值运动速度 (a)及其比值 (e/a)。放射免疫法分析血浆心钠素 (ANP)、脑钠素(BNP)、内皮素 (ET)、降钙素基因相关肽 (CGRP)及血清胰岛素样类生长因子 1(IGF 1)的浓度。结果 高血压病LVH组与NLVH组及对照组比较 ,e波峰值速度降低 ,[分别为 (14 .5 6± 7.83 )cm /s、(16.40± 0 .66)cm /s、(18.68± 3 .78)cm/s] ,a波峰值速度增高 ,[分别为 (18.2 8± 9.60 )cm/s、(16.0 3± 5 .88)cm/s、(14 .5 3± 1.2 8)cm /s] ;LVH和NLVH组的e波及a波峰值速度与对照组比较 ,差异有显著性意义 (P <0 .0 5 ) ;对照组、高血压病NLVH组、LVH组二尖瓣侧环e/a值依次显著减小 (1.42± 0 .11,0 .88± 0 .12 ,0 .74± 0 .0 9,P <0 .0 0 1)。对照组、高血压病NLVH组、LVH组血浆ET、ANP、BNP及血清IGF 1浓度依次显著升高 (P <0 .0 0 1) ;对照组、高血压病NLVH组、LVH组血浆CGRP浓度依次显著降低 (P <0 .
Objective To study the changes of diastolic function of left ventricle by tissue Doppler imaging (TDI) and the serum level of endocrine factors,and analyse the relations between these factors and mass or diastolic function of left ventricle in patients with essential hypertension.Methods Sixty one patients with essential hypertension were divided into left ventricular hypertrophy(LVH) group and no left ventricular hypertrophy(NLVH) group.Twenty healthy subjects were considered as control group.The early(e) and late(a) diastolic maximal myocardial velocity and e/a of lateral wall motion of mitral valve annulus were recorded by TDI.The levels of atrial natritic peptide(ANP),brain natriuretic peptide(BNP),endothelium(ET),calcitonic gene related peptide(CGRP) and insulin like growth factor 1(IGF 1) were measured by radio immunology analysis.Results The e wave maximal velocity in LVH group was lower than that of NLVH group and control group [( 14.56 ± 7.83 ) cm/s,( 16.40 ± 0.66 ) cm/s,( 18.68 ± 3.78 ) cm/s,respectively],and a wave maximal velocity in LVH group was higher than that of NLVH group and control group [( 18.28 ± 9.60 ) cm/s,( 16.03 ± 5.88 ) cm/s ,( 14.53 ± 1.28 ) cm/s,respectively]; The e and a maximal velocity velocities in both LVH and NLVH groups had statistic differences with those of control group(P< 0.05 ).The e/a of wall motion of mitral valve annulus decreased gradually in control group,NLVH group and LVH group ( 1.42 ± 0.11 , 0.88 ± 0.12 , 0.74 ± 0.09 ,P< 0.001 ).ET,ANP,BNP and IGF 1 all increased in NLVH group(P< 0.001 ) and increased further in LVH group,while CGRP decreased in NLVH group (P< 0.001 ) and decreased further in LVH group.There were moderate correlations between the endocrine factors with e/a(r= 0.60 ,P< 0.01 ).Conclusions The decreased diastolic function of left ventricle assessed by TDI correlates with changes of the endocrine factors in the patients with hypertension.
出处
《中华超声影像学杂志》
CSCD
2004年第12期885-887,共3页
Chinese Journal of Ultrasonography
基金
卫生部资助项目 (WKZ 2 0 0 0 1 0 3)
