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目的应用超声二维应变成像技术评价高血压患者的颈动脉血管弹性。方法选取2012年1月至12月在天津医科大学第二医院心内科住院的高血压患者120例(1、2和3级高血压组)和正常血压及正常高值血压者40人(对照组)。所有入选对象均行心脏超声检查及颈动脉彩色多普勒超声心动图(彩超)检查,应用二维应变成像技术测量颈动脉短轴方向收缩期峰值整体圆周应变、收缩早期整体圆周应变率(CSr)、收缩晚期整体CSr绝对值,计算僵硬系数(β1和β2)。结果随着血压升高,室间隔厚度(IVST)[(8.2±1.4)、(9.1±1.1)、(9.4±1.4)、(11.2±2.2)mm]、左心室后壁厚度(LVPWT)[(8.5±1.1)、(8.6±1.0)、(9.2±1.4)、(10.7±2.2)mm]、左心室质量指数(LVMI)[(53.3±10.8)、(59.6±15.8)、(60.2±10.1)、(76.4±26.2)g/m2]、β2[(0.6±0.1)、(0.8±0.2)、(0.9±0.2)、(1.1±0.2)]逐渐升高;而收缩期峰值整体圆周应变[(6.0±0.7)%、(5.4±0.1)%、(5.0±0.3)%、(4.7±0.4)%]、收缩早期整体CSr(×10)[(7.1±0.8)/s、(6.3±0.6)/s、(5.5±0.5)/s、(5.1±0.5)/s]降低(均P<0.05)。相关性分析显示,LVMI与收缩期峰值整体圆周应变、收缩早期整体CSr和收缩晚期整体CSr绝对值呈负相关;与β2呈正相关。结论高血压患者收缩期整体圆周应变、收缩早期整体CSr随血压水平增高而减小,β2随着血压水平的增高增大,提示随着血压增高颈动脉僵硬度增加,超声二维应变成像技术可作为一项诊断血管弹性病变的新技术。
Objective To evaluate the elasticity of carotid artery in hypertensive patients by two-dimensional ultrasound imaging. Methods One hundred and twenty patients with hypertension (group 1,2 and 3) and 40 patients with normal blood pressure and normal high blood pressure who were hospitalized in Department of Cardiology, Second Hospital of Tianjin Medical University from January to December 2012 were selected (control group ). All the subjects underwent echocardiography and carotid color Doppler echocardiography (color Doppler) examination. Two-dimensional strain imaging was used to measure the global circumferential strain of the systolic peak and the global circumferential strain rate (CSr ), Contracting the overall CSr absolute value of the late stage, and calculating the stiffness coefficient (β1 and β2). Results With the increase of blood pressure, the thickness of interventricular septum (IVST) [(8.2 ± 1.4), (9.1 ± 1.1), (9.4 ± 1.4), (11.2 ± 2.2) mm], LVPWT [ (8.5 ± 1.1), (8.6 ± 1.0), (9.2 ± 1.4) and (10.7 ± 2.2) mm respectively. LVMI, , (76.4 ± 26.2) g / m2] and β2 [(0.6 ± 0.1), (0.8 ± 0.2), (0.9 ± 0.2) and (1.1 ± 0.2)], respectively; while the peak global systolic strain [ (7.1 ± 0.8) / s, (6.3 ± 0.6)%, (5.4 ± 0.1)%, (5.0 ± 0.3)%, (4.7 ± 0.4)%] (5.5 ± 0.5) / s, (5.1 ± 0.5) / s] (all P <0.05). Correlation analysis showed that LVMI was negatively correlated with the total circumferential strain in systolic peak, the overall CSr in early systole and the absolute value of total CSr in late systole, and positively correlated with β2. Conclusion The overall circumferential strain of systolic phase in systolic blood pressure and the overall CSr in early systolic phase decrease with the increase of blood pressure level, and β2 increases with the increase of blood pressure level, suggesting that with the increase of arterial stiffness, the two-dimensional ultrasound imaging technology As a diagnosis of vascular elasticity of the new technology.