CAJ | 학술논문

目的采用三维斑点追踪技术(3D-STI)测定不同构型原发性高血压(EH)患者的左室整体功能指数(GPI),并评价3D-STI相关参数与GPI的相关性.方法将入选的164例原发性高血压患者依照左室构型分型标准依次分为:左室正常构型组(LVN,67例)、左室向心性重构组(CCR,49例)、左室向心性肥厚组(CCH,28例)和左室离心性肥厚组(ECH,20例),并选择30例与患者组年龄、性别匹配的健康志愿者作为对照组.采用3D-STI获取各组左室收缩期整体三维应变及扭转参数,并计算收缩不同步指数(SDI)和GPI,比较各组参数间的差异,分析其与GPI的相关性.结果与正常对照组相比,原发性高血压患者各组GPI、左室整体纵向收缩峰值应变(GLS)、整体纵向收缩峰值面积应变(GAS)、整体纵向收缩峰值应变(GRS)和整体三维应变(G3 DS)均明显减低,差异均具有统计学意义(P＜0.05).而CCH组和ECH组的SDI高于对照组,差异亦具有统计学意义(P＜0.05).多元逐步回归结果显示,GAS对GPI影响最大.结论基于3D-STI的GPI可较好地评价原发性高血压患者左室的整体活动及功能,具有一定的临床价值.
목적 채용삼유반점추종기술(3D-STI)측정불동구형원발성고혈압(EH)환자적좌실정체공능지수(GPI),병평개3D-STI상관삼수여GPI적상관성.방법 장입선적164례원발성고혈압환자의조좌실구형분형표준의차분위:좌실정상구형조(LVN,67례)、좌실향심성중구조(CCR,49례)、좌실향심성비후조(CCH,28례)화좌실리심성비후조(ECH,20례),병선택30례여환자조년령、성별필배적건강지원자작위대조조.채용3D-STI획취각조좌실수축기정체삼유응변급뉴전삼수,병계산수축불동보지수(SDI)화GPI,비교각조삼수간적차이,분석기여GPI적상관성.결과 여정상대조조상비,원발성고혈압환자각조GPI、좌실정체종향수축봉치응변(GLS)、정체종향수축봉치면적응변(GAS)、정체종향수축봉치응변(GRS)화정체삼유응변(G3 DS)균명현감저,차이균구유통계학의의(P＜0.05).이CCH조화ECH조적SDI고우대조조,차이역구유통계학의의(P＜0.05).다원축보회귀결과현시,GAS대GPI영향최대.결론 기우3D-STI적GPI가교호지평개원발성고혈압환자좌실적정체활동급공능,구유일정적림상개치.
Objective To investigate the left ventricular (LV) performance in patients with essential hypertension(EH) by global performance index (GPI) based on three-dimensional speckle tracking imaging (3D-STI).Methods A total of 164 EH patients were enrolled and divided into four subgroups according to LV configuration:LV normal group (LVN,n =67),concentric cardiac remodeling group (CCR,n =49),concentric cardiac hypertrophy group (CCH,n =28) and eccentric cardiac hypertrophy group (ECH,n =20).Thirty age and sex matched healthy volunteers were enrolled as controls.3D-STI was performed to assess LV 3D global strain and LV torsion,then LV systolic dyssynchrony index (SDI) and global performance index (GPI) were calculated.Global strain parameters were investigated among the groups,and correlations with GPI were studied.Results GPI,global longitudinal strain(GLS),global area strain(GAS),global radial strain(GRS) and global 3D strain(G3DS) in EH groups were respectively lower than those in the normal controls,and there were statistical differences among the respective parameters (P ＜0.05,respectively).SDI in group CCH and ECH were significantly higher than that in normal controls (P ＜ 0.05,respectively).In multivariate stepwise regression analysis,GAS was the most influential to GPI.Conclusions GPI based on 3D-STI may accurately reflect LV performance in patients with EH,and has potential applications in clinical practice.