孤立性室间隔基底段肥厚的高血压患者左心室及流出道形态和血流动力学改变的超声评估

发布时间：2018-10-12 20:50

【摘要】：目的应用超声心动图评估孤立性室间隔基底段肥厚(IBSH)的高血压患者左心室及流出道形态及血流动力学特点。方法使用超声心动图测量193例IBSH及200例非IBSH高血压患者的左心室射血分数(LVEF)、短轴缩短率(FS)、左心室质量指数(LVMI)、室间隔基底段厚度(IVSB)、室间隔中间段厚度(IVSM)、室间隔心尖段厚度(IVSA)、左心室后壁厚度(LVPWT)、收缩期及舒张期二尖瓣附着平面与主动脉夹角(Angle)、静息及多巴酚丁胺负荷下左心室流出道最大血流速度(LVOT-V_(max))、压力阶差(PG_(mean)),对比两组间上述参数测值差异。结果 IBSH组与非IBSH组间IVSB[(15.1±1.6)比(12.2±1.4)mm]、IVSM[(9.3±0.9)比(10.7±1.3)mm]、IVSA[(10.3±1.1)比(10.9±0.9)mm]、LVMI[(69.5±12.3)比(77.3±14.8)g/m~2]差异有统计学意义(P0.01);LVPWT[(9.5±0.7)比(9.4±0.8)mm]、FS[(35.7±4.3)%比(35.4±3.1)%]及静息状态下两组LVOT-V_(max)[(1.7±0.9)比(1.6±0.9)m/s]、PG_(mean)[(8.1±1.2)比(7.9±0.9)mm Hg]差异无统计学意义(均P0.05);多巴酚丁胺药物负荷下IBSH组LVOT-V_(max)[(3.0±0.4)比(2.0±0.3)m/s]、PG_(mean)[(21.6±1.7)比(10.6±0.5)mm Hg]测值明显大于非IBSH组(均P0.05)。结论静息状态下IBSH患者无左心室流出道血流动力学异常,但在负荷状态下可引起左心室流出道梗阻。
[Abstract]:Objective to evaluate the morphologic and hemodynamic characteristics of left ventricle and outflow tract in hypertensive patients with isolated basal segment hypertrophy of ventricular septum (IBSH) by echocardiography. Methods left ventricular ejection fraction (LVEF),) shortening rate of left ventricular ejection fraction (LVEF),) was measured by echocardiography in 193 patients with IBSH and 200 patients with non IBSH hypertension. (FS), left ventricular mass index (LVMI),) was used to measure the thickness of the basal segment of the ventricular septum (LVMI),) and the thickness of the middle segment of the ventricular septum (IVSM),) of the ventricular septum. Segmental thickness (IVSA), left ventricular posterior wall thickness (LVPWT), systolic and diastolic mitral valve attachment plane and aortic angle (Angle), rest and dobutamine load left ventricular outflow tract maximal flow velocity (LVOT-V_ (max), pressure step difference (PG_ (mean),) were compared between the two groups. 缁撴灉 IBSH缁勪笌闈濱BSH缁勯棿IVSB[(15.1卤1.6)姣，

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