【摘要】：目的應(yīng)用斑點(diǎn)追蹤成像技術(shù)(speckle tracking imaging, STI)評(píng)價(jià)構(gòu)型正常的原發(fā)性高血壓患者早期左心室心肌的舒縮功能。 方法選取左心室充盈正常的高血壓患者40例(A組),左心室松弛性減低的高血壓患者40例(B組),健康對(duì)照者30例(正常對(duì)照組),應(yīng)用STI分別測(cè)量左心室長(zhǎng)軸切面、心尖四腔心切面、兩腔心切面整體心肌和心內(nèi)膜下心肌基底段、中間段、心尖段收縮期長(zhǎng)軸應(yīng)變率(GSrL S),舒張?jiān)缙陂L(zhǎng)軸應(yīng)變率(GSrL E),房縮期長(zhǎng)軸應(yīng)變率(GSrL A),通過(guò)左心室短軸心底水平和心尖水平分別計(jì)算心底水平旋轉(zhuǎn)角度峰值(MV-Prot)、心尖水平旋轉(zhuǎn)角度峰值(AP-Prot)、扭轉(zhuǎn)角度峰值(Ptw)、收縮末期扭轉(zhuǎn)角度(AVCtw)、等容舒張末期扭轉(zhuǎn)角度(MVOtw)、等容解扭轉(zhuǎn)率(UntwR)、解旋減半時(shí)間(UHT)等左心室扭轉(zhuǎn)-解旋參數(shù)。 結(jié)果與正常對(duì)照組相比,A組患者心內(nèi)膜下心肌收縮期應(yīng)變率減低(P0.01),心內(nèi)膜下心肌和整體心肌舒張?jiān)缙趹?yīng)變減低(P0.05),房縮期心內(nèi)膜下心肌應(yīng)變?cè)龈?P0.05),心底水平旋轉(zhuǎn)角度峰值、心尖水平旋轉(zhuǎn)角度峰值、扭轉(zhuǎn)角度峰值,收縮期末扭轉(zhuǎn)角度、等容舒張期末扭轉(zhuǎn)角度增加(P0.05),等容解扭轉(zhuǎn)率減低(P0.05),解扭轉(zhuǎn)減半時(shí)間延長(zhǎng)(P0.05)；B組患者較正常對(duì)照組收縮期應(yīng)變減低(P0.05),舒張期早期應(yīng)變減低(P0.05),房縮期應(yīng)變?cè)龈?PO.05),心底水平旋轉(zhuǎn)角度峰值、心尖水平旋轉(zhuǎn)角度峰值、扭轉(zhuǎn)角度峰值、收縮期末扭轉(zhuǎn)角度、等容舒張期末扭轉(zhuǎn)角度增加(P0.05),等容解扭轉(zhuǎn)率減低(P0.05),解扭轉(zhuǎn)減半時(shí)間延長(zhǎng)(P0.05)。與A組相比,B組患者心尖水平旋轉(zhuǎn)角度峰值進(jìn)一步增加(P0.05),等容解扭轉(zhuǎn)率進(jìn)一步減低(P0.05)。 結(jié)論應(yīng)用STI技術(shù)通過(guò)檢測(cè)左心室長(zhǎng)軸心內(nèi)膜下心肌的應(yīng)變率和扭轉(zhuǎn)、解旋參數(shù)可以定量分析左心室心肌的應(yīng)變情況,準(zhǔn)確評(píng)價(jià)原發(fā)性高血壓患者左心室心肌功能的早期損傷。
[Abstract]:Objective to evaluate the diastolic and contractile function of left ventricular myocardium in hypertensive patients with normal configuration by dot tracing imaging (speckle tracking imaging, STI). Methods 40 hypertensive patients with normal left ventricular filling (group A), 40 hypertensive patients with impaired left ventricular relaxation (group B) and 30 healthy controls (normal control group) were selected. Left ventricular long axis sections were measured by STI. Apical four-chamber section, two-chamber section of the whole myocardium and subendocardial myocardial basal segment, middle segment, apical segment systolic long-axis strain rate (GSrL S), early diastolic long-axis strain rate (GSrL E), atrial contraction long-axis strain rate (GSrL A), The peak values of basal horizontal rotation angle (MV-Prot), apical horizontal rotation angle (AP-Prot), torsion angle peak (Ptw), end systolic torsion angle (AVCtw), were calculated from the left ventricular short axis bottom level and apical level, respectively. Isovolemic end-diastolic torsion angle (MVOtw), isovolumetric solution torsion rate (UntwR), deconvolution half-time (UHT) and other left ventricular torsion-deconvolution parameters. Results compared with the normal control group, the systolic strain rate of subendocardial myocardium and the early diastolic strain of subendocardial and global myocardium in group A were lower (P0.01), and that in group A was lower than that in control group (P0.05). During atrial contraction period, the subendocardial myocardial strain increased (P0.05), the peak of the horizontal rotation angle at the bottom of the heart, the peak of the horizontal rotation angle of the apex, the peak of the torsion angle, the torsion angle at the end of contraction, and the end-torsion angle at the end of isovolumetric relaxation (P0.05). The isovolumetric solution torsion rate was decreased (P0.05), and the solution torsion reduced half time was prolonged (P0.05); In group B, systolic strain decreased (P0.05), early diastolic strain decreased (P0.05), atrial contraction strain increased (PO.05), the peak of horizontal rotation angle of the heart floor, the peak of horizontal rotation angle of heart tip, and the peak of horizontal rotation angle of heart tip were observed in group B as compared with the normal control group (P0.05). The peak torsion angle, the torsion angle at the end of contraction, the torsion angle at the end of isovolumetric relaxation were increased (P0.05), the rate of isovolemic solution torsion was decreased (P0.05), and the half-time of solution torsion was prolonged (P0.05). Compared with group A, the peak of horizontal rotation angle of heart tip in group B was further increased (P0.05), and the torsion rate of isometric solution was further decreased (P0.05). Conclusion the strain rate and torsion of left ventricular long axis subendocardial myocardium can be measured by STI technique and the strain of left ventricular myocardium can be quantitatively analyzed and the early injury of left ventricular function can be accurately evaluated in patients with essential hypertension.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R544.1;R540.45

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