摘要
目的 研究二维斑点追踪成像(two-dimensional speckle tracking imaging, 2D-STI)技术联合组织多普勒成像(tissue doppler imaging, TDI)技术对不同左心室构型原发性高血压患者左室舒张功能的诊断价值。方法 回顾性选取2020年12月~2021年12月齐齐哈尔市第一医院收治的123例原发性高血压患者,根据Ganau分型法分为左心室构型正常组(LVN组)34例和左心室重构组(LVR组)89例。其中LVR组又可分为离心性心肌肥厚组(ECH组)12例,与向心性重构组(CCR组)25例、向心性肥厚组(CCH组)52例。所有患者均行常规经胸超声心动图检查、TDI和2D-STI技术检查完成左室舒张功能评价。分析比较各组间的常规经胸超声心动图参数、左室舒张功能不全评价参数、左心房容积指数(LAVI)、E波(舒张早期)/运动速度峰值(e′)(E/e′)之间的关系。结果 由单因素和logistic回归分析可得,平均收缩压、平均舒张压、左心房容积指数LAVI、E/e′为原发性高血压患者左心室构型是否正常的重要影响因素(P<0.05)。采用Hosmer-Lemeshow检验得χ^(2)=3.537,P=0.901,拟合度好;ROC曲线下面积(AUC)为0.934,95%CI为0.891~0.977(P<0.05),灵敏度为85.4%,特异度为88.2%。E/e′、LAVI和三尖瓣反流速度(TR)从LVN~ECH组逐渐升高,EH组显著高于其他各组,差异有统计学意义(P<0.05),其他各组间差异无统计学意义(P> 0.05);LAVI除LVN与CCR外,其余各组间差异有统计学意义(P<0.05);TR除CCR组与ECH组外,其他各组间差异无统计学意义(P> 0.05)。LASr、LAScd和LASct从LVN~ECH组逐渐降低。LASr除CCR组与CCH外,其余各组间均具有统计学意义(P<0.05);LAScd在组间对比均具有统计学意义(P<0.05);LASct除CCR组与CCH外,其余各组间差异均具有统计学意义(P<0.05)。左心房储备期应变(LASr)、左心房管道期应变(LAScd)及助力泵阶段应变(LASct)与LAVI及E/e′均呈负相关(r=-0.283、-0.346、-0.357,-0.524、-0.345、-0.267,P<0.05)。结论 2D-STI技术联�
Objective To investigate the diagnostic value of two-dimensional speckle tracking imaging(2D-STI)combined with tissue Doppler imaging(TDI)for assessing left ventricular diastolic function in patients with various forms of essential hypertension.Methods A total of 123 outpatients and inpatients with essential hypertension admitted to the Department of Cardiology,the First Hospital of Qiqihar City from December 2020 to December 2021 were selected.Employing the Ganau classification method,participants were categorized a normal left ventricular geometry(LVN)group comprising 34 cases and a left ventricular remodeling(LVR)group consisting of 89 cases.The LVR group was further divided into 12 cases of eccentric myocardial hypertrophy(ECH),25 cases of concentric remodeling(CCR)group and 52 cases of concentric hypertrophy(CCH)group.All patients underwent conventional transatlantic echocardiography,TDI examination,and 2D-STI examination to complete the evaluation of left ventricular diastolic function.The echocardiography parameters,left ventricular diastolic dysfunction(LVDD),Lavi and e′were compared among the groups.Results Univariate and logistic regression analysis showed that mean systolic blood pressure,mean diastolic blood pressure,left atrial volume index(LAVI)and E′were the important influencing factors of left ventricular essential hypertension(P<0.05).Using Hosmer-Lemeshow test,χ^(2)=3.537,P=0.901,good fit;of the area under the ROC curve(AUC)was 0.934,95%Cl was 0.891-0.977(P<0.05),sensitivity was 85.4%and specificity of 88.2%.E e′,LAVI,and TR were gradually increased from the LVN to ECH group.The EH group was significantly higher than the other groups(P<0.05)and there was no significant difference between the other groups;LVI except LVN and CCR(P<0.05);no significant difference between TR except CCR and ECH(P>0.05).The LASr,LAScd,and LASct were gradually decreased from the LVN to ECH group.LASr except CCR and CCH(P<0.05);LAScd was statistically significant(P<0.05);LASct except CCR and CCH(P<0.05).LASr,LAS
作者
李孟书
陈笑寒
赵思文
Li Mengshu;Chen Xiaohan;Zhao Siwen(Department of Ultrasound Diagnosis,the First Hospital of Qiqihar,Qiqihar 161000,China)
出处
《中华保健医学杂志》
2024年第3期265-269,共5页
Chinese Journal of Health Care and Medicine
基金
齐齐哈尔市科技计划创新激励项目(CSFGG-2023123)。
关键词
组织多普勒成像技术
二维斑点追踪成像
左心室舒张功能
原发性高血压
左心室构型
左室舒张功能不全分级
Tissue doppler imaging
Two-dimensional speckle tracking imaging
Essential hypertension
Left ventricular configuration
Left ventricular diastolic dysfunction classification
