目的 探讨超声心动图左室舒张容积变化系列参数评估高血压病患者左室舒张功能的临床价值.方法 分别选取原发性高血压左室肥厚及无肥厚患者28例、30例及正常对照组28例,所有对象均行常规超声心动图检测,测算传统评估左室舒张功能的各项指标,并由双平面Simpson法测得心脏舒张期不同时刻的左室容积,计算左室舒张容积变化系列参数.结果 (1)三组间左室舒张容积变化系列参数VE、VA、VER、VAR、SVE、SVA、SVER、SVAR、VE/VA、VER/VAR差异存在统计学意义(P＜0.05); (2) VE/VA和VER/VAR诊断左室舒张功能不全的ROC曲线下面积分别为0.975和0,962,以VE/VA＞ 1.93为截断值诊断左室舒张功能不全的敏感性为94.9％,特异性为91,5％,以VER/VAR＞0.76为截断值诊断左室舒张功能不全的敏感性为89.7％,特异性为90.4％; (3) VE/VA和VER/VAR与左室舒张功能分级显著相关(r=-0.90,P＜0.001; r=-0.88,P＜0.001).结论 左室舒张容积变化系列参数可以反映左室充盈性、顺应性及整体舒张功能的变化,在左室舒张功能不全诊断和分级方面优于传统指标.%Objective To study the clinical value of left ventricular diastolic volume change parameters by echo-cardiogram in patients with essential hypertension. Methods Fifty-eight patients with essential hypertension were divided into hypertrophy group and no hypertrophy group with twenty eight healthy subjects as control. All subjects underwent routine echocardiography examination. Conventional diastolic function indexes were measured. Left ventricular diastolic volume change parameters were calculated in different diastolic process. Results (1) The difference of VE, VA, VER, VAR, SVE, SVA, SVER, SVAR, VE/VA and VER/VAR were statistically significant (P< 0. 05); (2) The Az of VE/VA and VER/VAR were 0. 975 and 0. 962. The sensitivity and specificity of VE/VA is 94. 9% and 91. 5% with a cut-off value of 1. 93 for diastolic dysfunction. The sensitivity and specificity of VER/VAR was 89. 7% and 90. 4% with a cut-off value of 0. 76 for diastolic dysfunction; (3) VE/VA and VER/VAR correlated well with diastolic function classification( r= - 0. 90,P<0. 001 ;r= -0. 88,P<0. 001). Conclusions Left ventricular diastolic volume change parameters can reflect relaxation, compliance and diastolic function and it is superior to traditional index in diagnosing and grading left ventricular diastolic dysfunction.
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