二维斑点追踪超声评价餐后低血压对左室心肌应变的影响

发布时间：2018-01-22 15:02

本文关键词： 餐后低血压二维斑点追踪超声成像心脏功能心肌应变　出处：《上海交通大学学报(医学版)》2016年06期 　论文类型：期刊论文

【摘要】：目的采用二维斑点追踪超声成像(2D-STI)定量评价餐后低血压(PPH)患者左心室心肌应变的早期损害。方法入选首次诊断PPH患者20例,21例非PPH患者对照。应用2D-STI测定2组餐前及餐后1.5 h左心室整体纵向应变(GLS)、环周应变(GCS)和径向应变(GRS),同时用常规方法测量心脏结构和功能。结果常规方法检测2组心脏结构功能无显著差异。餐前PPH组GLS显著低于非PPH组(P=0.02),GCS、GRS无显著差异。对比2组患者餐前、餐后心肌应变,发现PPH组餐后1.5 h GLS(P=0.045)显著下降,而非PPH组餐前餐后整体心肌应变无显著差异。采用Logistic回归分析,餐前GLS(P=0.02,OR=0.46),餐后GLS(P=0.001,OR=0.27)、GCS(P=0.008,OR=0.41)、GRS(P=0.004,OR=0.33)和PPH具有显著相关性。餐后GLS的ROC曲线下面积(AUC=0.86,P=0.001)显著大于24 h平均SBP(AUC=0.66,P=0.08)和左室射血分数(AUC=0.44,P=0.47)。结论 PPH可能会引起心脏功能隐匿性损害。相比常规心脏超声检查,STI技术能更容易发现PPH左心室心肌功能的早期损害。
[Abstract]:Objective to quantitatively evaluate the early damage of left ventricular myocardial strain in patients with postprandial hypotension (PPH) by two-dimensional speckle tracing ultrasonography (2D-STI). Methods Twenty patients with PPH were selected for the first time. 21 patients without PPH were treated with 2D-STI. The global longitudinal strain of left ventricle (GLSs), circumferential strain and radial strain were measured by 2D-STI before and 1.5 hours after meal. Results there was no significant difference in cardiac structure and function between the two groups by routine method. GLS in PPH group was significantly lower than that in non-#en2# group. There was no significant difference in GRS between the two groups. Compared with the preprandial and postprandial myocardial strain in the two groups, it was found that the PPH group decreased significantly at 1.5 h postprandial. There was no significant difference in postprandial global myocardial strain in non-#en0# group. Using Logistic regression analysis, preprandial GLSN P0. 02 OR 0.46). GCS P0. 001 / 0. 27 GCS P0. 008 / 0. 41 GRS / P0. 004. The area under ROC curve of postprandial GLS was 0.86. P0. 001) was significantly higher than that of 24 h mean SBP AUC (0. 66G) and left ventricular ejection fraction (LVEF) AUC 0. 44 (P < 0. 001). Conclusion PPH may lead to occult damage of cardiac function. Compared with conventional echocardiography, it is easier to detect the early damage of left ventricular function in PPH.
【作者单位】：上海交通大学医学院附属仁济医院老年病科;
【分类号】：R445.1;R544.2
【正文快照】： 餐后低血压(postprandial hyotension,PPH)是老年人的常见病,是指进餐后2 h内收缩压下降≥20mm Hg(1 mm Hg=0.133k Pa)并出现低血压的症状。近年文献证实,PPH与晕厥、跌倒、心绞痛及脑血管事件等临床问题相关[1],是老年人全因死亡的一个独立预测因子[2]。二维斑点追踪超声成像

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