摘要
目的探讨Tei指数联合组织多普勒(DTI)评价原发性高血压不同左室构型左室功能的临床价值。方法超声观察98例原发性高血压患者和32例正常人的心脏结构和功能。采用美国超声协会推荐的方法测量室间隔(IVS)、左室后壁厚度(LVPW)及左室舒张末内径(LVDd),并记录左室射血分数(EF)和短轴缩短率(FS)、二尖瓣血流频谱图舒张早期与舒张晚期血流峰值比(E/A)、左室Tei指数,组织多普勒测二尖瓣前叶瓣环运动频谱图收缩期运动幅度S峰及舒张早期与舒张晚期峰速比(Ea/Aa)。结果与正常对照组相比,原发性高血压左室正常构型组(Ⅰ组,25例)、向心性重构组(Ⅱ组,28例)、向心性肥厚组(Ⅲ组,23例)E/A值均<1,与正常组间差异有显著性意义,高血压离心性肥厚组(Ⅳ组,22例)E/A>1,呈假性正常;Ⅱ、Ⅲ、Ⅳ组与正常对照组比较,S值减低(P<0.01);高血压各组Ea/Aa值均<1(P<0.01);Ⅳ组EF值显著低于正常对照组(P<0.01),其余患者EF、FS与正常对照组间无显著性差异;高血压各组Tei指数均较正常对照组增加,呈递增趋势,Ⅲ组与Ⅰ组,Ⅳ组与Ⅰ、Ⅱ、Ⅲ、组间差异有显著性意义;Tei指数和S值、Ea/Aa、EF均为负相关(r分别为-0.44、-0.34、-0.47,P分别小于0.01、0.05、0.01),Tei指数和E/A值无相关性(P>0.05)。结论Tei指数联合DTI能简便、敏感、综合评价原发性高血压患者不同左室构型的收缩和舒张功能。
Objective To explore the clinical value of Tei index and Doppler tissue imaging（DTI） in assessment of left ventricular function in patients with essential hypertension with different pattern of left ventricular geometric model. Methods The total of 98 patients with essential hypertension and 32 healthy subjects were studied on echocardiography. The end-diastolic diameters of left ventricle （LVDd）, interventricular septum thickness （IVS）, left ventricular posterior wall thickness （LVPW）, E/A ratio （E/A） at mitral orifice, Ea/Aa ratio （Ea/Aa） and S at anterior mitral annulus were detected with DTI and left ventricular ejection fraction （EF） and Tei index were measured. Resuits Compared with the normal group, E/A in hypertension with normal left ventricle （group Ⅰ , 25 cases）, concentric remodeling （ group Ⅱ, 28 cases）, concentric hypertrophy （ group Ⅲ, 23 cases） were lower , E/A in hypertension with eccentric hypertrophy （group Ⅳ, 22 cases） was 〉1, it was pseudonormalization. Ea/Aa was 〈 1 in all hypertension groups and S was decreased in groups Ⅱ ,Ⅲ, Ⅳ. EF was greatly decreased only in group Ⅳ. Tei index of all patients were increased than that in the normal. There was significant difference between group Ⅰ and Ⅲ, as well as between group Ⅳ and Ⅰ , Ⅱ, Ⅲ. Tel index was negatively correlated with S, Ea/Aa, EF and was not correlated with E/A. Conclusion Tel index and DTI are valuable and easy in estimation left ventricular systolic and diastolic functions with high sensitivity.
出处
《苏州大学学报（医学版）》
CAS
北大核心
2006年第5期783-785,792,共4页
Suzhou University Journal of Medical Science
