【摘要】 目的:探讨超声二维应变(2DS)评价左心室不同构型原发性高血压患者的左心室心肌分层应变收缩功能的应用价值。方法:选取70例原发性高血压患者,行常规超声心动图检查,依据左心室心肌质量指数分为:左心室肥厚组(LVH组,32例)和非左心室肥厚组(NLVH组,38例)。40例健康志愿者作为对照组。应用2DS获取所有患者左心室节段不同水平即心尖位切面心内膜层、心肌中层和心外膜层心肌收缩期纵向峰值应变(SSL)。结果:(1)对照组、NLVH组和LVH组患者心肌各层SSL均保持梯度特征,即心内膜层>心肌中层>心外膜层。(2)与对照组比较,NLVH组和LVH组左心室节段不同水平的心内膜层心肌SSL均减低,心尖四腔水平:[(-24.11±3.52)%和(-22.78±4.11)%vs(-27.49±2.95)%],心尖两腔水平:[(-22.79±5.20)%和(-21.92±4.88)%vs(-27.95±3.13)%,心尖左心室长轴水平:(-20.07±3.43)%和(-21.34±3.64)%vs(-27.24±3.05)%],差异均有统计学意义(P均<0.05);虽然心肌中层和心外膜层SSL有所减低,但差异均无统计学意义(P>0.05)。(3)与NLVH组比较,LVH组心尖左心室长轴水平心肌中层[(-17.77±4.35)%v(s-21.73±3.97)%]和心外膜层心肌[(-14.25±3.78)%vs(-18.27±2.96)%]SSL均减低,差异均有统计学意义(P均<0.05)。Pearson相关系数:由2位医师不同时间2次检测结果,分别为心内膜层心肌SSL r=0.876,心肌中层SSL r=0.838,心外膜层心肌SSL r=0.823(P均<0.05)。结论:应用2DS可定量评价原发性高血压患者左心室心肌分层应变,为早期诊断高血压心脏病变和判断心肌受累程度提供一种无创的检查方法。更多还原

【Abstract】 Objective: To evaluate different patterns for left ventricular configuration on ventricular systolic function in patients with primary hypertension by two-dimensional strain(2DS) echocardiography.Methods: Our research included in 2 groups: Control group, n=40 healthy volunteers, Primary hypertension group, n=70, based on left ventricular mass index, the patients were further divided into 2 subgroups as Left ventricular hypertrophy(LVH) subgroup, n=32 and Non-left ventricular hypertrophy(NLVH) subgroup, n=38. The peaks of systolic longitude strain(SSL) for left ventricular apical layers of subendocardium, midmyocardium and epicardium were compared among different groups.Results:(1) In Control group and LVH, NLVH subgroups, SSL in different myocardium layers were kept in gradient features as subendocardium > midmyocardium > epicardium.(2) Compared with Control group, NLVH and LVH subgroups showed decreased SSL of subendocardium, as in apical four chamber level:(-24.11 ± 3.52) % and(-22.78 ± 4.11) % vs(-27.49 ± 2.95) %, in apical two chamber level:(-22.79 ± 5.20) % and(-21.92 ± 4.88) % vs(-27.95 ± 3.13) %, and in apical long-axis leve l :(- 2 0. 0 7 ± 3. 4 3) %a n d(-21.34 ± 3.64%)% vs(-27.24 ± 3.05) %, all P <0.05; while SSL in midmyocardium and epicardium were similar, P >0.05.(3) Compared with NLVH subgroup, LVH subgroup presented decreased SSL of long-axis, in midmyocardium(-17.77 ± 4.35) % vs(-21.73 ± 3.97) % and in epicardium(-14.25 ± 3.78) % vs(-18.27 ± 2.96) %, all P<0.05. The pearson correlation coefficient calculated by 2 physicians at 2 different times showed that SSL of subendocardium was r=0.876, of midmyocardium was r=0.838 and of epicardium was r=0.823, all P<0.05.Conclusion: 2DS may quantitatively evaluate the layered myocardial strain of left ventricle, it provided a non-invasive examination for early diagnosing and estimating the heart involvement with severity in patients of primary hypertension.更多还原