CAJ | 학술논문

目的：利用脉冲多普勒评价原发性高血压患者心室重构及舒张功能的改变。方法随机选择原发性高血压患者126例(高血压组)，按照左室质量指数(LVMI)分为左室肥厚(LVH)组66例和无左室肥厚(NLVH)组60例。对照组为体检健康者(40例)。M型及二维超声常规测量，转为组织多普勒(TDI)测量左房室瓣环侧壁处(LVAP)、右房室瓣环侧壁处(RVAP)组织舒张早期(Em)与舒张晚期(Am)的速度峰值，并计算Em/Am比值。结果 LVH组、NLVH组的IVS、LA、LVPW、RVAW均值分别为(12.2±0.9) mm、(42.9±3.1) mm、(12.3±0.8) mm、(5.4±1.0) mm和(9.5±1.4) mm、(39.1±3.0) mm、(8.9±1.2) mm、(4.5±0.7) mm，对照组则分别为(8.3±0.7) mm、(35.4±2.2) mm、(7.8±1.0) mm、(4.3±0.7) mm，LVH组的IVS、LA、LVPW、RVAW与NLVH组和对照组比较明显增加，差异均有统计学意义(P<0.05)；LVH组RVAP处的Em及Em/Am比值分别为(8.8±2.5) cm/s、(0.59±0.17)，LVAP处分别为(9.1±2.2) cm/s、(0.58±0.15)， NLVH组RVAP处的Em及Em/Am比值分别为(11.3±2.5) cm/s、(0.77±0.15)，LVAP处分别为(11.8±2.4) cm/s、(0.91±0.09)，对照组RVAP处的Em及Em/Am比值分别为(13.8±3.1) cm/s、(1.09±0.21)，LVAP处分别为(13.5±3.8) cm/s、(1.13±0.19)。LVH组、NLVH组RVAP、LVAP处的Em及Em/Am比值均明显低于对照组，差异均有统计学意义(P<0.05)；LVH组RVAP及LVAP的Em及Em/Am比值低于NLVH组，差异均有统计学意义(P<0.05)。结论原发性高血压早期可出现右心舒张功能的减退，随病程发展出现左室肥厚时可进一步影响右室重构及右室功能。
목적：이용맥충다보륵평개원발성고혈압환자심실중구급서장공능적개변。방법수궤선택원발성고혈압환자126례(고혈압조)，안조좌실질량지수(LVMI)분위좌실비후(LVH)조66례화무좌실비후(NLVH)조60례。대조조위체검건강자(40례)。M형급이유초성상규측량，전위조직다보륵(TDI)측량좌방실판배측벽처(LVAP)、우방실판배측벽처(RVAP)조직서장조기(Em)여서장만기(Am)적속도봉치，병계산Em/Am비치。결과 LVH조、NLVH조적IVS、LA、LVPW、RVAW균치분별위(12.2±0.9) mm、(42.9±3.1) mm、(12.3±0.8) mm、(5.4±1.0) mm화(9.5±1.4) mm、(39.1±3.0) mm、(8.9±1.2) mm、(4.5±0.7) mm，대조조칙분별위(8.3±0.7) mm、(35.4±2.2) mm、(7.8±1.0) mm、(4.3±0.7) mm，LVH조적IVS、LA、LVPW、RVAW여NLVH조화대조조비교명현증가，차이균유통계학의의(P<0.05)；LVH조RVAP처적Em급Em/Am비치분별위(8.8±2.5) cm/s、(0.59±0.17)，LVAP처분별위(9.1±2.2) cm/s、(0.58±0.15)， NLVH조RVAP처적Em급Em/Am비치분별위(11.3±2.5) cm/s、(0.77±0.15)，LVAP처분별위(11.8±2.4) cm/s、(0.91±0.09)，대조조RVAP처적Em급Em/Am비치분별위(13.8±3.1) cm/s、(1.09±0.21)，LVAP처분별위(13.5±3.8) cm/s、(1.13±0.19)。LVH조、NLVH조RVAP、LVAP처적Em급Em/Am비치균명현저우대조조，차이균유통계학의의(P<0.05)；LVH조RVAP급LVAP적Em급Em/Am비치저우NLVH조，차이균유통계학의의(P<0.05)。결론원발성고혈압조기가출현우심서장공능적감퇴，수병정발전출현좌실비후시가진일보영향우실중구급우실공능。
Objective To evaluate ventricular remodeling and diastolic function changes in patients with pri-mary hypertension by pulsed Doppler. Methods A total of 126 patients with essential hypertension were selected and divided them into the left ventricular hypertrophy group (Group LVH, with 66 cases) and non left ventricular hypertro-phy group (Group NLVH, with 60 cases) according to the left ventricular mass index (LVMI). And 40 of healthy peo-ple were selected as the control group. Routine tests of Type M and two-dimensional ultrasonography were performed, the early (Em) and late (Am) diastolic peak velocity of the left (LVAP) and right (RVAP) atrioventricular valve ring wall by adopting tissue Doppler imaging (TDI) were measured, then the ratio of Em/Am was calculated. Results The mean value of IVS, LA, LVPW and RVAW of Group LVH and Group NLVH, were respectively (12.2±0.9) mm, (42.9±3.1) mm, (12.3±0.8) mm, (5.4±1) mm and (9.5±1.4) mm, (39.1±3) mm, (8.9±1.2) mm, (4.5±0.7) mm. The mean values of con-trol group were (8.3 ± 0.7) mm, (35.4 ± 2.2) mm, (7.8 ± 1) mm, (4.3 ± 0.7) mm. The IVS, LA, LVPW, RVAW of Group LVH increased significantly than those of Group NLVH and control group. The differences were statistically signifi-cant (P<0.05). In Group LVH, the Em and Em/Am ratio of RVAP and LVAP were respectively (8.8 ± 2.5) cm/s, (0.59 ± 0.17) cm/s and (9.1 ± 2.2) cm/s, (0.58 ± 0.15) cm/s. In Group NLVH, the Em and Em/Am ratio of RVAP and LVAP were respectively (11.3 ± 2.5) cm/s, (0.77±0.15) cm/s and (11.8±2.4) cm/s, (0.91±0.09) cm/s. In control group, the Em and Em/Am ratio of RVAP and LVAP were respectively (13.8 ± 3.1) cm/s, (1.09 ± 0.21) cm/s and (13.5±3.8) cm/s, (1.13 ± 0.19) cm/s. The Em and Em/Am ratio of RVAP and LVAP in Group LVH and Group NLVH were both signifi-cantly lower than those of the control group. The differences were statistically significant (P<0.05). The Em and Em/Am ratio of RVAP and LVAP in Group LVH were lower than those in Group NLVH. The differences were statistically significant (P<0.05). Conclusion Impairment of right ventricular diastolic function can occur in early essential hy- <br> pertension. With the course of development, left ventricular hypertrophy may further influence the remodeling and function of right ventricular.