【摘要】 目的　采用心肌背向散射积分 (IBS)技术评价高血压病患者心肌病变的严重程度 ,并探讨其与左室舒张功能的关系。方法　高血压病组 117例和对照组 30例 ,二维超声心动图获取左室射血分数 (EF) ;脉冲多普勒 (PW)获取二尖瓣口血流速率 E/ A、 E峰下降时间 (DT)与等容舒张时间 (IVRT) ;脉冲多普勒组织成像技术 (PW- DTI)获得二尖瓣环舒张早期峰值速率Em;运用 IBS测量和分析 :室间隔 (IVS)和左室后壁 (L VPW)的心肌背向散射积分 (IBS)、校正 IBS (IBS% )、 IBS周期变化幅度 (CVIB)、跨壁梯度 (TGIB)及左室平均 CVIB (averaged CVIB,ACVIB)。结果　根据 E/ A、 Em、 IVRT将原发性高血压患者分为 4组 :舒张功能正常组 (组 1)、松弛异常组 (组 2 )、充盈假性正常化组 (组 3)、限制性左室充盈障碍组 (组 4 )。 (1)组 1与对照组的 IBS%、 CVIB、 TGIB之间无显著差异性 ,而舒张功能异常组(组 2、组 3、组 4 )与对照组相比 ,IBS%增高、 CVIB减低、 TGIB增高 ;(2 )相关回归分析表明舒张功能异常组 ACVIB的变化与 DT、 IVRT相关 ,ACVIB的减低与 Em减低密切相关。结论　超声背向散射积分技术可反映高血压患者心肌病变的严重程度 ,评价其舒张功能 ,有一定的临床应用价值更多还原

【Abstract】 Objective To assess the myocardial lesions with ultrasonic integrated backscatter(IBS) parameters and discuss its relationship with the diastolic function of the left ventricle in patients with hypertension.Methods A total of 117 essential hypertension patients and 30 normal subjects as control group were examined with 2-D,PW-Doppler,DTI and IBSEF,E/A,DT,IVRT and Em(mitral annular early diastolic peak velocity),Myocardial IBS,normalized IBS(IBS%),cyclic variation of IBS(CVIB),transmural gradient of IBS(TGIB),averaged CVIB(ACVIB) of interventricular septum(IVS) and left ventricular posterior wall(LVPW) were measured and analyzed.Results Essential hypertension patients were divided into 4 groups according to E/A,Em and IVRT:group 1(n=34),group 2(n=28),group 3(n=36) and group 4(n=19)(1)There were significant differences in IBS%,CVIB and between patients with abnormal diastolic function and the controls(2)ACVIB (averaged CVIB) of the left ventricle was correlated with DT,IVRT and with Em significantly.Conclusions Ultrasonic integrated backscatter is valuable in reflecting the severity of microvascular lesions in myocardium and in assessing the diastolic function of hypertension patients.更多还原