CAJ | 학술논문

目的：探讨实时三维斑点追踪成像（RT3D-STI）技术在评价高血压患者左室收缩功能中的应用价值。方法选择经临床确诊的100例高血压患者，其中左室正常构型组（LVN）55例，左室重构组（LVR）45例，同期选取正常对照组50例，应用彩超的RT3D-STI技术采集心尖全容积成像，获取各组左室舒张末容积（LVEDV）、左室收缩末容积（LVESV）、左室射血分数（LVEF）、左室质量指数（LVMI）、舒张早期二尖瓣血流速度/舒张晚期二尖瓣血流速度（E/A）、左室整体长轴应变（GLS）、左室整体轴向应变（GCS）、左室整体径向应变（GRS）及左室整体面积应变（GAS）等。结果正常对照组、LVN组及LVR组3组间LVEF差异无统计学意义（P>0.05）；LVR组LVEDV、LVESV、LVMI、相对室壁厚度（RWT）明显高于正常对照组及LVN组，差异有统计学意义（P<0.05）；而E/A显著低于正常对照组及LVN组（P<0.05）。LVN组与正常对照组相比，GLS、GAS降低，差异有统计学意义（P<0.05），GRS、GCS无明显变化（P>0.05）。LVR组GLS、GCS、GRS、GAS均低于正常对照组及LVN组（P<0.05）。结论 RT3D-STI技术可反映高血压患者左室收缩功能的改变，提示高血压患者在早期射血功能正常时已存在收缩功能的改变。
목적：탐토실시삼유반점추종성상（RT3D-STI）기술재평개고혈압환자좌실수축공능중적응용개치。방법선택경림상학진적100례고혈압환자，기중좌실정상구형조（LVN）55례，좌실중구조（LVR）45례，동기선취정상대조조50례，응용채초적RT3D-STI기술채집심첨전용적성상，획취각조좌실서장말용적（LVEDV）、좌실수축말용적（LVESV）、좌실사혈분수（LVEF）、좌실질량지수（LVMI）、서장조기이첨판혈류속도/서장만기이첨판혈류속도（E/A）、좌실정체장축응변（GLS）、좌실정체축향응변（GCS）、좌실정체경향응변（GRS）급좌실정체면적응변（GAS）등。결과정상대조조、LVN조급LVR조3조간LVEF차이무통계학의의（P>0.05）；LVR조LVEDV、LVESV、LVMI、상대실벽후도（RWT）명현고우정상대조조급LVN조，차이유통계학의의（P<0.05）；이E/A현저저우정상대조조급LVN조（P<0.05）。LVN조여정상대조조상비，GLS、GAS강저，차이유통계학의의（P<0.05），GRS、GCS무명현변화（P>0.05）。LVR조GLS、GCS、GRS、GAS균저우정상대조조급LVN조（P<0.05）。결론 RT3D-STI기술가반영고혈압환자좌실수축공능적개변，제시고혈압환자재조기사혈공능정상시이존재수축공능적개변。
Objective To evaluate left ventricular systolic function in patients with hypertension by real-time three-dimension speckle tracking imaging (RT3D-STI).Methods Among 100 cases of clinically diagnosed patients with hypertension involved in this study, there were 55 cases in LVN (Left Ventricular Geometry) Group and 45 cases in LVR (Left Ventricular Remodeling) Group. Additionally, 50 healthy volunteers were selected as Control Group. RT3D-STI was applied for obtainment of apical full-volume imaging and acquisition of LVEDV (Left Ventricular End Diastolic Volume), LVESV (Left Ventricular End Systolic Volume), LVEF (Left Ventricular Ejection Fraction), LVMI (Left Ventricular Mass Index), E/A ratio, left ventricular GLS (Global Longitudinal Strain), left ventricular GCS (Global Circumferential Strain), left ventricular GRS (Global Radial Strain) and left ventricular GAS (Global Area Strain).Results No statistically signiifcant differences were seen in LVEF between Control Group, LVN Group and LVR Group (P>0.05). LVEDV, LVESV, LVMI and RWT (Relative Wall Thickness) in LVR Group were remarkably higher versus those of Control Group and LVN Group, with statistically signiifcant differences, whereas the E/A was notably lower than that of Control Group and LVR group (P<0.05). In comparison with Control Group, GLS and GAS in LVN Group were signiifcantly decreased with statistical differences (P<0.05), but GCS and GRS had no obvious changes (P>0.05). Compared with those of Control Group and LVN Group, the GLS, GCS, GRS and GAS were further decreased in LVR Group (P<0.05).Conclusion RT3D-STI could sensitively relfect the changes in left ventricular systolic function in patients with hypertension, indicating the existence of changes in systolic function for hypertension patients whose ejection function was normal in the early stage.