应用二维斑点追踪技术早期评价高血压患者左心房功能的研究

发布时间：2018-04-22 19:11

本文选题：高血压 + 阵发性房颤　；参考：《重庆医科大学》2017年硕士论文

【摘要】：目的:探索应用二维斑点追踪技术(two-dimensional speckle tracking imaging,2D-STI)能否早期评价高血压患者左房功能。方法:选取高血压患者78例,据病史分为单纯高血压组(HP)46例,高血压伴阵发性房颤组(HP+PAF)32例,据左房容积指数(left atrial volume index,LAVI)分为左心房容积正常组(LAN)42例和扩大组(LAE)组36例,另选取健康人群30例为对照组。所有病例均行常规心脏超声检查,并采用Simpson法测量左房容积(left atrial volume,LAV),计算左房容积指数(left atrial volume index,LAVI)。运用二维斑点追踪技术(2D-STI)获取左房各壁于左室收缩期峰值应变率(SRs)、左室舒张早期峰值应变率(SRe)与左室舒张晚期峰值应变率(SRa),并计算左房整体平均峰值应变率(m SRs、m SRe、m SRa)。结果:对照组、HP组、HP+PAF组的m SRs、m SRe绝对值依次减小,三组间均有统计学意义。HP组、HP+PAF组m SRa绝对值较对照组增大,HP+PAF组m SRa绝对值较HP组减小(P0.05)。对照组、LAN组、LAE组的m SRs、m SRe绝对值依次减小,三组间均有统计学意义,LAN组、LAE组m SRa绝对值较对照组增大有统计学意义(P0.05)。结论:高血压患者左心功能较健康人群下降,合并房颤时下降更加明显。左房容积正常的高血压患者左心房功能较健康人群已有下降,左房容积增大时左心功能进一步下降。提示2D-STI比左心房容积更敏感,能早期评价高血压患者左心房功能改变,为临床及早干预提供了依据。
[Abstract]:Aim: to explore whether two-dimensional speckle tracking imaging2D-STI can early evaluate left atrial function in patients with hypertension. Methods: Seventy-eight patients with hypertension were divided into four groups: hypertension group (n = 46), hypertension with paroxysmal atrial fibrillation group (n = 46), left atrial volume index group (n = 42), left atrial volume control group (n = 42) and enlarged group (n = 36). Another 30 healthy people were selected as control group. All patients were examined by conventional echocardiography, left atrial volume was measured by Simpson method and left atrial volume index was calculated. Two dimensional speckle tracing technique was used to obtain the peak strain rate (SRS), early diastolic peak strain rate (SReN) and late diastolic peak strain rate (SRA) of each wall of left atrium at left ventricular systolic stage, and to calculate the global mean peak strain rate of left atrium. Results: the absolute value of m SRS m SRe in HP PAF group decreased in turn. The absolute value of m SRa in HP PAF group was significantly higher than that in HP PAF group and decreased P 0. 05% in HP PAF group. The absolute value of mSRsm SRe in the control group was decreased in turn, and the absolute value of m SRa in the LAE group was significantly higher than that in the control group (P 0.05). Conclusion: left ventricular function in patients with hypertension is lower than that in healthy subjects, especially in patients with atrial fibrillation. Left atrial function in hypertensive patients with normal left atrial volume was lower than that in healthy subjects, and left ventricular function decreased further when left atrial volume increased. The results suggest that 2D-STI is more sensitive than left atrial volume and can be used to evaluate the changes of left atrial function in patients with hypertension.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.3;R540.45

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