【摘要】 目的:通过二维斑点追踪显像技术(2D-STI)定量评价尿毒症高血压和原发性高血压患者左室收缩及舒张功能,并进行对比研究。方法:对30例正常人(A组),35例原发性高血压(B组)和60例尿毒症高血压患者(包括射血分数正常的C1组32例和射血分数减低的C2组28例)采集左室短轴基底水平和心尖水平图像进行二维斑点追踪分析,可得出左室基底部旋转角度峰值(Prot-B)、心尖部旋转角度峰值(Prot-A)、整体扭转角度峰值(PtwAll)及达峰时间(T-Ptw)、收缩末期扭转角度(AVCtw)、解旋率(UntwR)和解旋减半时间(HTU)。并分析扭转和解旋参数与常规超声指标之间的相关性。结果:1扭转参数的比较,原发性高血压组扭转增强(Prot-B、Prot-A、Ptw-All、AVCtw增加,T-Ptw缩短,P<0.05);尿毒症高血压C1组扭转减弱(Prot-B、Prot-A、Ptw-All、AVCtw降低,T-Ptw延长,P<0.05);C2组减弱更显著,差异均有统计学意义(P<0.05)。2解旋参数的比较,UntwR和HTU在正常对照组、原发性高血压组、尿毒症高血压C1组、尿毒症高血压C2组依次降低,差异有统计学意义(P<0.05)。3整体扭转角度峰值Prot-All与LVEF呈正相关,与LVEDD呈负相关;解旋率UntwR与LAD相关性较强,r=-0.663,P<0.05。结论:原发性高血压患者左室扭转运动增强,解旋能力降低,尿毒症高血压左室扭转运动减低,解旋功能更低。2D-STI技术可早期识别尿毒症高血压和原发性高血压心肌力学改变,为临床提供重要信息。更多还原

【Abstract】 Objective:To assess the left ventricular function in uremia hypertension patients by two dimensional-speckle tracking imaging(2D-STI).Methods:Thirty healthy controls,thirty-five primary hypertension patients and sixty uremia hypertension(which were divided into C1 group with normal ejected fraction,n=32;and C2 group with decreased ejected fraction,n=28)patients were studied.The imaging of base and apex level of left ventricular were analyzed by 2D-STI.Prot-B,Prot-A,Ptw-All,T-Ptw,AVCtw,UntwR and HTU were acquired.The correlation were analyzed between torsion and untwisting parameters with conventional indexes.Results:1By comparison of torsion parameters,in primary hypertension group,the Prot-B,Prot-A,Ptw-All,AVCtw were increased,T-Ptw was shortened(P<0.05).In uremia hypertension C1 group,the Prot-B,Prot-A,Ptw-All,AVCtw were decreased,T-Ptw was prolonged(P<0.05);in uremia hypertension C2 group,the torsion parameters were decreased more significantly(P<0.05).2The comparsion of UntwR and HTU were gradually decreasing from control group to uremia hypertension C2 group,all untwisting parameters had significant difference between them(P<0.05).3The Ptw-All had a positive correlation with LVEF,but had a negative correlation with LVEDD.The UntwR had a significantly negative correlation with LAD(r=-0.663,P<0.05).Conclusion:The torsion of left ventricular in primary hypertension patients are increased,but the untwisting are decreased;the torsion and untwisting function in uremia hypertension are both decreased.2D-STI could play important roles in the evaluation of left ventricular function between primary hypertension and uremia hypertension patients.更多还原