摘要
目的:应用二维斑点追踪显像(2D-STI)和实时三维超声心动图(RT-3DE)观察高血压病患者左房结构和功能的早期改变,定量评价左房重构的特征性。方法:随机选择无明显并发症的117例高血压病患者和68名健康体检者,在常规超声心动图检查的基础上,运用RT-3DE和2D-STI观察其左房结构和功能改变,筛选出62例左房容积指数(LAVmaxI)<28 ml/m2的高血压病患者和62名健康体检者,并将其分别纳入高血压病组和健康对照组,应用RT-3DE对两组进行容积-时间曲线分析,比较两组左房容积指标的最大容积(LAVmax)、最小容积(LAVmin)、收缩前容积(LAVp),以及左房总的射血分数(LATEF)、被动射血分数(LAPEF)、主动射血分数(LAAEF)及LAVmaxI、LAVminI、LAVpI,并进行收缩期左房各房壁平均应变(mSs)及收缩期、舒张早期和舒张晚期应变率(mSRs、mSRe和mSRa)心房肌应变曲线分析。结果:高血压病组与健康对照组相比,患者mSRe减小,而mSRa和LAAEF增大,差异有统计学意义(t=-2.79,t=2.54,t=2.81;P<0.05);相关分析中患者mSRe、mSRa与舒张压、收缩压、LVMI和Ep/Ap均存在相关性(r舒张压=-0.36,r=0.32,r收缩压=-0.49,r=0.35,rLVMI=-0.65,r=0.45,rEp/Ap=0.32,r=-0.28;P<0.05),而与LVDD、LVEF、年龄、血糖、血脂和血胆固醇均无相关性。结论:左房大小正常的高血压病患者收缩期左房应变及应变率无显著性变化,但与左房心肌舒张早期应变率下降、舒张晚期应变率及RT-3DE反映的左房主动射血分数增大的左室质量变化和血压水平等密切相关,2D-STI结合RT-3DE有望成为评价高血压病左房重塑早期表达的一种可靠的新方法。
Objective:To observe the early changes of left atrial structure and function of patients with hypertension by using two-dimensional speckle tracking imaging(2D-STI)and real-time three-dimensional echocardiography(RT-3DE)so as to quantitatively evaluate the characteristics of left atrial remodeling.Methods:A total of 117 patients with hypertension who didn’t appear obvious complications and 68 healthy persons who underwent physical examination were randomly selected in this research.Based on the conventional echocardiography,RT-3DE and 2D-STI were used to observe the structure and functional changes of left atrium.62 patients with hypertension whose left atrial volume index(LAVmax I)<28 ml/m2 and 62 healthy persons were divided into hypertension group and control group,respectively.The volume-time curve analysis of the two groups was performed by using RT-3DE,and series of left atrial volume(LAV)indexes included maximum volume(LAVmax),minimum volume(LAVmin),pre-contraction volume(LAVp),total ejection fraction(LATEF),passive ejection fraction(LAPEF),active ejection fraction(LAAEF),LAVmaxI,LAVminI,LAVpI of two groups were analyzed and compared.The analyses of mean systolic strain(m Ss)of the left atrial wall in systole stage,m SRs,m SRe,m SRa and strain curve of atrial muscle were implemented.Results:Compared with that of control group,m SRe of hypertension group was significantly decreased while m SRa and LAAEFof hypertension group were significantly increased(t=-2.79,t=2.54,t=2.81,P<0.05).Correlation analysis showed that there was significant correlation between m SRe and DBP,SBP,LVMI,Ep/Ap,and between m SRa and DBP,SBP,LVMI,Ep/Ap(rDBP=-0.36,r=0.32,rSBP=-0.49,r=0.35,rLVMI=-0.65,r=0.45,rEp/Ap=0.32,r=-0.28,P<0.05),respectively.While they didn’t have significant correlation with LVDD,LVEF,age,blood glucose,blood lipids and blood cholesterol.Conclusion:In hypertensive patients with normal left atrial size,there is no significant change in systolic left atrial strain and strain rate.While they were closely related
作者
戴法辉
龚元淑
薛袁园
DAI Fa-hui;GONG Yuan-shu;XUE Yuan-yuan
出处
《中国医学装备》
2020年第1期43-47,共5页
China Medical Equipment
基金
南京市医学科技发展项目(YKK16250)“斑点追踪及实时三维超声在高血压病左心房重构早期诊断中的研究”
关键词
二维斑点追踪
实时三维超声显像
高血压病
左房重构
Two-dimensional speckle tracking(2D-ST)
Real-time three-dimensional echocardiography(RT-3DE)
Hypertension
Left atrial remodeling
