超声心动图对高血压病人左室舒张功能再评价

摘要

Purpose To assess left ventricular diastolic function in the patients with essentialhypertension. Methods 25 normotensives,93 hypertensiives without hypertrophy (NLVH) and 47 withhypertrophy (LVH)(LVMI, left ventricular mass index ＞ 124 g/m2 in males and 110 g/m2 in females)underwent 2DE and Doppler echocardiography. Results The ratio of early to late peak velocity (E/A)was 1.21 ± 0.24 in normotensives and 1.03 ± 0.23 in NLVH patients( P ＜ 0.01 ); reversed pulmonaryvenous flow at atrial systole PA wave was (32.7 ± 7.5 ) vs (38.9 ± 8.7) cm/s (P ＜ 0.01 ) in normotensivesand in NLVH patients respectively. The isovolumic relaxation time (IVRT) and left atrial dimension (LAD)have significant differences in three groups ( P ＜ 0. 05 - 0. 001 ). EF value was similar betweennormotensives and NLVH patients, but it was lower in LVH patients ( P ＜ 0.01 ). Conclusions E/Aratio, PA wawe, Pai, IVRT and LAD are sensitive parameters indicating mild diastolic left ventriculardysfunction. Systolic left ventricular function has no change in NLVH patients.%目的 探讨超声心动图对高血压(EH)病人左室舒张功能评价价值。方法 140例EH病人分为左室肥厚组47例，非左室肥厚组93例，予二维超声心动图及Doppler频谱检测，并与25例正常人对照。结果 在正常组和NLVH组，E/A比值、PA值和PAi有显著差异；IVRT、LAD在3组之间有显著差异；EF％值在NLVH组与正常组相似，与LVH组差异有统计学意义。结论 PA、PAi增高、E/A比值减低、IVRT延长和LAD增大是EH左室舒张功能减低的敏感指标。EF值变化提示EH早期左室收缩功能并未受到影响，随着疾病进展而逐步受损。