本文選題：高血壓 + 陣發(fā)性房顫�。� 參考：《重慶醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探索應(yīng)用二維斑點(diǎn)追蹤技術(shù)(two-dimensional speckle tracking imaging,2D-STI)能否早期評價高血壓患者左房功能。方法:選取高血壓患者78例,據(jù)病史分為單純高血壓組(HP)46例,高血壓伴陣發(fā)性房顫組(HP+PAF)32例,據(jù)左房容積指數(shù)(left atrial volume index,LAVI)分為左心房容積正常組(LAN)42例和擴(kuò)大組(LAE)組36例,另選取健康人群30例為對照組。所有病例均行常規(guī)心臟超聲檢查,并采用Simpson法測量左房容積(left atrial volume,LAV),計算左房容積指數(shù)(left atrial volume index,LAVI)。運(yùn)用二維斑點(diǎn)追蹤技術(shù)(2D-STI)獲取左房各壁于左室收縮期峰值應(yīng)變率(SRs)、左室舒張早期峰值應(yīng)變率(SRe)與左室舒張晚期峰值應(yīng)變率(SRa),并計算左房整體平均峰值應(yīng)變率(m SRs、m SRe、m SRa)。結(jié)果:對照組、HP組、HP+PAF組的m SRs、m SRe絕對值依次減小,三組間均有統(tǒng)計學(xué)意義。HP組、HP+PAF組m SRa絕對值較對照組增大,HP+PAF組m SRa絕對值較HP組減小(P0.05)。對照組、LAN組、LAE組的m SRs、m SRe絕對值依次減小,三組間均有統(tǒng)計學(xué)意義,LAN組、LAE組m SRa絕對值較對照組增大有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:高血壓患者左心功能較健康人群下降,合并房顫時下降更加明顯。左房容積正常的高血壓患者左心房功能較健康人群已有下降,左房容積增大時左心功能進(jìn)一步下降。提示2D-STI比左心房容積更敏感,能早期評價高血壓患者左心房功能改變,為臨床及早干預(yù)提供了依據(jù)。
[Abstract]:Aim: to explore whether two-dimensional speckle tracking imaging2D-STI can early evaluate left atrial function in patients with hypertension. Methods: Seventy-eight patients with hypertension were divided into four groups: hypertension group (n = 46), hypertension with paroxysmal atrial fibrillation group (n = 46), left atrial volume index group (n = 42), left atrial volume control group (n = 42) and enlarged group (n = 36). Another 30 healthy people were selected as control group. All patients were examined by conventional echocardiography, left atrial volume was measured by Simpson method and left atrial volume index was calculated. Two dimensional speckle tracing technique was used to obtain the peak strain rate (SRS), early diastolic peak strain rate (SReN) and late diastolic peak strain rate (SRA) of each wall of left atrium at left ventricular systolic stage, and to calculate the global mean peak strain rate of left atrium. Results: the absolute value of m SRS m SRe in HP PAF group decreased in turn. The absolute value of m SRa in HP PAF group was significantly higher than that in HP PAF group and decreased P 0. 05% in HP PAF group. The absolute value of mSRsm SRe in the control group was decreased in turn, and the absolute value of m SRa in the LAE group was significantly higher than that in the control group (P 0.05). Conclusion: left ventricular function in patients with hypertension is lower than that in healthy subjects, especially in patients with atrial fibrillation. Left atrial function in hypertensive patients with normal left atrial volume was lower than that in healthy subjects, and left ventricular function decreased further when left atrial volume increased. The results suggest that 2D-STI is more sensitive than left atrial volume and can be used to evaluate the changes of left atrial function in patients with hypertension.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R541.3;R540.45

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