三维超声斑点追踪技术对原发性高血压患者早期左心室纵向收缩功能变化的评估价值

摘要

Objective:To study the assessment value of 3-dimensional speckle tracking imaging (3D-STI)for changes of early left ventricular longitudinal systolic function in patients with primary hypertension.Methods:Patients with primary hy-pertension who were treated in our hospital from May 2012 to October 201 5 were selected,and 40 patients with left ventricular normal (LVN)primary hypertension and 40 patients with left ventricular remodeling (LVR)primary hypertension were screened according to Ganau typing and enrolled in the LVN group and LVR group of the study respectively;40 cases of healthy volunteers who received physical examination in our hospital during the same period were selected as control group.Ul-trasonic testing was conducted to determine conventional ultrasonic indicators and 3D-STI parameters,and serum was collected to determine angiotensin (Ang)Ⅱ,aldosterone (ALD),transforming growth factor (TGF)-β1 and Ang1-7 levels.Results:left ventricular end-diastolic dimension (LVEDd),left ventricular posterior wall thickness (LVPWT)and left ventricular ejection fraction (LVEF)of LVN group were not significantly different from those of control group (P >0.05),LVEF of LVR group was not significantly different from those of LVN group and control group (P >0.05),and LVEDd and LVPWT of LVR group were significantly higher than those of LVN group and control group (P <0.05);absolute values of global longitudinal strain (GLS),global circumferential strain (GCS),global radial strain (GRS)and global area strain (GAS)as well as serum Ang1-7 level of LVN group was significantly lower than those of control group (P <0.05),serum AngⅡ,ALD and TGF-β1 levels were higher than those of control group (P <0.05),absolute values of GLS,GCS,GRS and GAS as well as serum Ang1-7 lev-el of LVR group was significantly lower than those of LVN group and control group,and serum AngII,ALD and TGF-β1 lev-els were higher than those of LVN group and control group (P <0.05 );absolute values of GLS,GCS,GRS and GAS were negatively correlated with serum AngⅡ,ALD and TGF-β1 levels (P <0.05),and positively correlated with serum Ang1-7 lev-el (P <0.05).Conclusions:3-dimensional speckle tracking imaging can be used for early evaluation of left ventricular longitudi-nal systolic function in patients with primary hypertension,and it also has high sensitivity in judging neurohumoral change.%目的：：研究三维超声斑点追踪技术(3D-STI)对原发性高血压患者早期左心室纵向收缩功能变化的评估价值.方法：选择2012年5月~2015年10月在我院就诊的原发性高血压患者,根据 Ganau 分型法筛选左心室构型正常(LVN)的原发性高血压患者40例和左心室重构(LVR)的原发性高血压患者40例,分别作为研究的 LVN 组和 LVR 组；选择同期在我院体检的40例健康志愿者作为对照组.行超声检查并测定常规超声指标、3D-STI 参数,采集血清并测定血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)、转化生长因子β1(TGF-β1)、Ang1-7含量.结果：LVN 组左心室舒张末期内径(LVEDd)、左心室后壁厚度(LVPWT)、左心室射血分数(LVEF)与对照组无显著性差异(P ＞0．05),LVR 组 LVEF 与 LVN 组、对照组均无显著性差异(P ＞0．05),LVR 组 LVEDd、LVPWT 显著高于 LVN 组、对照组(P ＜0．05)；LVN 组左心室整体圆周收缩期峰值应变(GCS)、左心室整体纵向收缩期峰值应变(GLS)、左心室整体面积应变(GAS)、左心室整体径向收缩期峰值应变(GRS)绝对值以及血清 Ang1-7含量均显著低于对照组(P ＜0．05),血清 AngⅡ、ALD、TGF-β1含量高于对照组(P ＜0．05),LVR 组 GLS、GCS、GRS、GAS绝对值以及血清 Ang1-7含量均显著低于 LVN 组和对照组(P ＜0．05),血清 AngⅡ、ALD、TGF-β1含量高于 LVN 组和对照组(P ＜0．05)；GLS、GCS、GRS、GAS 绝对值与血清 AngⅡ、ALD、TGF-β1含量呈负相关(P ＜0．05),与血清 Ang1-7含量呈正相关(P ＜0．05).结论：三维超声斑点追踪技术可以用于原发性高血压患者左心室纵向收缩功能的早期评估,在判断神经体液变化方面也具有较高敏感性.