【摘要】 目的探讨Tei指数对原发性高血压不同左室构型右室功能的应用价值。方法原发性高血压患者96例,按Ganau分类法将原发性高血压分为4型:正常左室构型(组,25例)、向心性重构(组,26例)、向心性肥厚(组,27例)、离心性肥厚(组,18例);正常对照组30例。以常规超声心动图检查测量舒张末期室间隔和后壁厚度及左室内径(IVS、LVPW、LVEDD),二、三尖瓣血流频谱图舒张早期与舒张晚期血流峰值比(E/A),二尖瓣前叶、三尖瓣隔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),左、右室射血分数(EF)以及Tei指数。结果、、组右室E/A<1,组>1,各组与对照组比较Ea/Aa均<1(P<0.05),组S值减低(P<0.05);组EF值低于正常对照组(P<0.05);高血压、、组Tei指数较对照组增加(0.40±0.16,0.50±0.14,0.68±0.58,0.28±0.03,P<0.05),、组间以及分别与、组间差异有显著性意义(P<0.05);右室Tei指数和右室S值、EF、Ea/Aa及左室EF为轻度负相关(r分别为-0.34,-0.5,-0.35,-0.36;P值均<0.01),与左室Tei指数呈正相关(r为0.55,P<0.01),而和E/A无相关性(P>0.05)。结论右室较左室Tei指数改变发生晚,提示右心整体功能损害晚于左心整体功能的损害。左、右心功能互相依赖,高血压左心功能损害时右心功能也受到了损害。Tei指数能简便、敏感、综合评价高血压病患者右室的收缩和舒张功能,是一项很有发展前途的评价心功能的多普勒超声新指标。更多还原

【Abstract】 Objective To explore the clinical value of Tei index in the assessment of right ventricular func-tion in patients with essential hypertension.Methods Ninety-six patients with essential hypertension were enrolled.According to Ganau categories,these patients were divided into four groups as follows:normal left ventricle(group Ⅰ,25 cases),concentric remodeling(group Ⅱ,26 cases),concentric hypertrophy(group Ⅲ,27 cases)and eccentric hypertrophy(group Ⅳ,18 cases),and 30 age-matched healthy subjects as the contral group.The end-diastolic diameters of left ventricle(LVEDD),interventricular septum thickness(IVS),left ventricular posterior wall thickness(LVPW),E/A ratio(E/A)of tricuspid orifice were measured.Ea/Aa ratio(Ea/Aa)and s at mitral and tricuspid annulus by Doppler tissue imaging were detected,right ventricular ejection fraction(EF) and Tei index were measured.Results Compared with the control group,Ea/Aa in four groups were lower than that of the normal and s was decreased in group Ⅳ.EF was greatly decreased only in group Ⅳ.Tei indices of groups Ⅱ,Ⅲ,Ⅳ were increased than that of the normal.There was significant difference between group Ⅲ andⅠ,Ⅱ,as well as between Ⅳ and Groups Ⅰ,Ⅱ,Ⅲ.Right ventricular Tei index was negatively correlated with right ventricular EF,Ea/Aa,left ventricular EF and was positively correlated with left ventricular Tei index.Conclusions Left ventricllar Tei index was increased earlier than that of the right ventricle hinted that left ventricular global function changed earlier than the right.Left and right ventricular functions would influence each other.Tei index was valuable and easy for estimating right ventricular systolic and diastolic functions with high sensitivity.更多还原