论文部分内容阅读
目的 探讨血压正常高值者组织多普勒(TDI)测定的Tei指数,以预测其左室功能是否发生早期改变.方法 选取我院心血管内科门诊及住院的血压增高者96例,以血压平均水平分为血压正常高值组46例,高血压组50例;另选取50例健康体检者作为正常血压组.检测各组左室二维形态及功能指标:主动脉根部内径(AO)、左室舒张末内径(LVED)、室间隔厚度(IVST)、左室后壁厚度(LVPWT)、左室射血分数(LVEF)、舒张早期二尖瓣血流速度(E)与舒张晚期二尖瓣血流速度(A)比值,计算左室质量(LVM)及其指数(LVMI);应用TDI记录并计算左室Tei指数、舒张早期峰值运动速度(Em)、舒张晚期峰值运动速度(Am)及其比值,并对上述参数进行比较分析.结果 血压正常高值组Tei指数高于正常血压组,低于高血压组,E/A、Em/Am随血压水平升高而降低,差异均有统计学意义(均P<0.05);高血压组Em低于正常血压组和血压正常高值组,差异均有统计学意义(均P<0.05),正常血压组Em与血压正常高值组比较差异无统计学意义;高血压组Am高于正常血压组,差异有统计学意义(P<0.05),与血压正常高值组比较差异无统计学意义;三组间LVEF比较差异无统计学意义.Tei指数与LVMI、IVST均呈正相关(r=0.740、0.695,均P<0.01),与E/A、Em/Am均呈负相关(r=-0.597、-0.542,均P<0.01).结论 Tei指数能反映血压正常高值者早期心脏总体功能改变情况,对早期监测预防高血压亚临床心功能损害,积极逆转心脏功能具有重要意义.“,”Objective To investigate the clinical application value of Tei index measured by tissue Doppler imaging in predicting early changes of left ventricular function in patients with prehypertension.Methods Ninty-six patients with elevated blood pressure from cardiovascular outpatients and inpatients in our hospital were enrolled.According to average blood pressure level , the patients were divided into two groups of prehypertension group(46 patients) and hypertension group (50 patients),and another 50 healthy examinees were selected as normotension group.The diameters of aortic root,end-diastolic diameters of left ventricle,interventricular septum thickness(IVST),left ventricular posterior wall thickness,left ventricle ejection fraction(LVEF), early diastole phase of mitral valve blood flow velocity(E), later diastole phase of mitral valve blood flow velocity(A),the ratio of E/A were recorded,left ventricular mass and left ventricular mass index(LVMI) were calculated.The left ventricle Tei index,early diastole peak velocity of movement(Em),and later diastole peak velocity of movement(Am) were recorded and calculated by tissue Doppler imaging,and the ratio of Em/Am was calculated.The indicators were compared between the groups.Results Tei index in prehypertension group was higher than that in normotension group,while lower than that in hypertension group.Meanwhile,E/A and Em/Am were decreased with the increase of the blood pressure,there were significant differences(all P<0.05).Em in hypertension group was higher than that in prehypertension group and normotension group(both P<0.05),while there was no significant difference between prehypertension group and normotension group.Am in hypertension group was higher than that in normotension group , there was significant difference(P<0 . 05). while there was no significant difference with the prehypertension group. There was no statistical significance of LVEF among three groups.Tei index had positivecorrelation with LVMI and IVST(r=0 . 740 , 0 . 695 , both P<0 . 01). Tei index had negative correlation with E/A and Em/Am (r=-0.597,0.542,both P<0.01).Conclusion Tei index is able to indicate the early changes of heart function in patients with prehypertension,and is crucial for early monitoring and prevention of hypertension and subclinical cardiac dysfunction,as well as positive reversal of heart function.