原发性高血压伴左心室肥厚患者的升主动脉弹性

发布时间：2018-03-31 03:16

本文选题：升主动脉　切入点：弹性　出处：《放射学实践》2017年11期

【摘要】：目的:探讨原发性高血压伴左心室肥厚(LVH)患者的升主动脉弹性特征。方法:192例诊断为原发性高血压患者采用128层双源CT行冠状动脉CT成像。将原始数据每间隔5%RR间期进行全时相重建。以垂直于左冠状动脉主干发出主动脉根部层面为参考平面,取其上25mm作为升主动脉兴趣层面。采用三个较常见的指标可扩张度(AD)、动脉顺应性(AC)、动脉僵硬度(ASI)评价升主动脉弹性。结果:原发性高血压伴LVH组52例(26.6%),不伴LVH组140例(73.4%)。伴LVH组和不伴LVH组间高血压病程和24h平均收缩压及脉压有统计学差异。伴LVH组的升主动脉AD[(1.71±0.96)×10~(-3) mmHg~(-1) vs(3.14±1.21)×10~(-3) mmHg~(-1)]和AC[(1.03±0.49)mm~2 mmHg~(-1) vs(1.72±0.79)mm~2 mmHg~(-1)]较不伴LVH组显著降低,而ASI(11.07±6.6vs 21.39±15.22)显著增加(P均0.001);俩组间升主动脉标化舒张期最小直径无统计学差异,最小面积和肱踝脉波传导速度(baPWV)有统计学差异(P0.05)。结论:高血压合并LVH患者的升主动脉弹性较无LVH者明显减退,其程度强于传统baPWV和形态学。在不增加医疗成本前提下,利用冠状动脉CT成像获得升主动脉弹性指标,对早期识别高血压LVH有一定的临床意义。
[Abstract]:Objective: to investigate the characteristics of ascending aorta elasticity in patients with essential hypertension with left ventricular hypertrophy. Methods: coronary artery CT imaging was performed in 192 patients with essential hypertension using 128-slice dual-source CT. The original data were measured at intervals of 5%RR. Full-time phase reconstruction was performed at intervals. The reference plane was perpendicular to the root of the aorta emitted from the main trunk of the left coronary artery. The ascending aorta elasticity was evaluated by three common indexes, such as dilatation degree, arterial compliance and arterial stiffness. Results: 52 cases of essential hypertension with LVH, without LVH, were selected to evaluate the elasticity of ascending aorta. There were significant differences in duration of hypertension, 24-hour mean systolic blood pressure and pulse pressure between LVH group and LVH group. The AD of ascending aorta in LVH group [1.71 卤0.96 脳 10 ~ (-3)) vs(3.14 卤1.21 脳 10 ~ (-3) vs(3.14 卤1.21 脳 10 ~ (-3) mm 路g ~ (-1)) and AC (1.03 卤0.49)mm~2 ~ (-1) vs(1.72 卤0.79)mm~2 ~ (-1)) were significantly lower than those without LVH. However, ASI(11.07 卤6.6vs 21.39 卤15.22 significantly increased the mean diastolic diameter of ascending aorta between the two groups (P < 0.01), but there was no significant difference in the minimum diastolic diameter of ascending aorta between the two groups. The minimum area and brachial malleolus wave conduction velocity (BAPWV) were significantly different (P 0.05). Conclusion: the ascending aorta elasticity of hypertension patients with LVH is significantly lower than that of patients without LVH, and its degree is stronger than that of traditional baPWV and morphology. It is of clinical significance to identify hypertension LVH in early stage by using coronary artery CT imaging to obtain ascending aortic elasticity index.
【作者单位】：邹城市人民医院放射科;曲阜市中医院CT室;大连医科大学附属第一医院心脏CT检查科;
【分类号】：R544.11;R816.2

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