二维斑点追踪技术评价高血压病人升主动脉弹性的应用研究

doi:10.3969/j.issn.1003-9198.2021.08.010

摘要/Abstract

摘要： 目的探讨采用二维斑点追踪技术评价原发性高血压病人升主动脉弹性特点的可行性。方法选取原发性高血压病人60例作为高血压组,另选取非高血压者60例作为对照组,2组分别按年龄再分为老年亚组(≥60岁)和非老年亚组(<60岁)。所有病例均采用超声心动图检查,使用2D-STI获取相应斑点追踪图像,分析主动脉应变率变化,同时计算动脉扩张度(AD)和动脉僵硬指数(ASI),并进行比较。结果高血压组AD值低于对照组,ASI值高于对照组,差异均有统计学意义(P<0.01)。高血压组和对照组的老年亚组AD均低于非老年亚组, ASI均高于非老年亚组(P<0.05);高血压组的2 个亚组与对照组的2个亚组间分别比较,上述指标差异亦有统计学意义(P<0.05)。结论高血压病人血管弹性减低,并随年龄增加而减低,预示着高血压是动脉弹性降低的重要危险因素,简化的二维斑点追踪分析作为一种无创的检查方法,评价升主动脉弹性的可行性较好,有一定的临床价值。

关键词: 二维斑点追踪技术, 高血压, 主动脉弹性, 动脉僵硬指数

Abstract: Objective To investigate the feasibility of two-dimensional speckle tracking imaging (2D-STI) in evaluating the aortic elasticity of the patients with essential hypertension(EH). Methods A total of 60 patients with EH were enrolled in EH group and 60 cases with normal blood pressure were selected as control group. According to the age, the two groups were divided into elderly subgroup(aged≥60 years old)and non-eldely subgroup (aged<60 years old) respectively. Echocardiography was performed in all cases and the corresponding speckle tracking images were acquired using 2D-STI. The changes of aortic strain rate was analyzed, and the arterial dilatation (AD) and arterial stiffness index (ASI) were calculated and compared. Results The value of AD was significantly lower and the value of ASI was significantly higher in EH group than that of control group(P<0.01).In the two groups, compared with non-elderly subgroup, the value of AD was lower and the value of ASI was higher in elderly subgroup(P<0.05); There were significant differences in the above indexes between the two subgroups in EH group and control group respectively(P<0.05). Conclusions Age and EH are important factors in the reduction of arterial elasticity. Simplified 2D-STI can evaluate the aortic elasticity and provide new ideas for clinical treatment of aortic diseases and has certain clinical value.

Key words: two-dimensional speckle tracking imaging, hypertension, aortic elasticity, arterial stiffness index

中图分类号:

R 544.1

沈艳, 陈祖乾, 侯晓慧, 程月红, 王莉, 郭珊. 二维斑点追踪技术评价高血压病人升主动脉弹性的应用研究[J]. 实用老年医学, 2021, 35(8): 829-832.

SHEN Yan, CHEN Zu-qian, HOU Xiao-hui, CHENG Yue-hong, WANG Li, GUO Shan. Application of two-dimensional speckle tracking technology in evaluating the elasticity of ascending aorta in patients with hypertension[J]. Practical Geriatrics, 2021, 35(8): 829-832.

参考文献

[1] 王胜煌,程劲松.冠心病合并高血压病人的血压管理[J].心脑血管病防治,2016,16(3): 174-177.
[2] 朱佳,杨性安,王刚,等.二维斑点追踪超声心动图评价急性心肌梗死病人左心房应变功能[J].心脑血管病防治,2015,15(2): 131-132.
[3] 袁彩娣,陈建荣,金美英,等.超声二维斑点追踪成像技术评价2型糖尿病病人右心室局部纵向收缩功能[J].心脑血管病防治,2015,15(6): 473-475,488.
[4] 李欣颖,刘展睿.二维斑点追踪技术在心血管疾病中的应用[J].世界最新医学信息文摘,2019,19(12): 58-61.
[5] MARIJANA T,CESARE C,BILJANA P, et al. High-normal blood pressure impacts the right heart mechanics: a three-dimensional echocardiography and two-dimensional speckle tracking imaging study[J]. Blood Press Monit,2014,19(3): 145-152.
[6] BIESEVICIENE M, VASKELYTE J J, MIZARIENE V, et al. Two-dimensional speckle-trackingechocardiography for evaluation of dilative ascending aorta biomechanics[J].BMC Cardiovasc Disord,2017,17(1): 17-27.
[7] SABLA L, AVENATTI E, CESAREO M, et al. Evaluation of aortic stiffness by a new simplified 2D speckle tracking analysis[J].Int J Cardiovasc Imaging, 2018,34(11): 1753-1760.
[8] 孟令红, 徐俊青, 贾崇富. 原发性高血压伴左心室肥厚病人的升主动脉弹性[J]. 放射学实践, 2017,32(11): 58-62.
[9] YEONG C J, HUN K K. Evaluation of arterial stiffness by echocardiography: methodological aspects[J]. Chonnam Med J,2016, 52(2): 101-106.
[10] 王鹏, 刘彩香. 透析病人sTWEAK与动脉硬化及炎症因子的相关性研究[J]. 中国继续医学教育, 2018, 10(35): 101-103.
[11] 贾崇富,王照谦. 影像学检查在主动脉弹性功能评估中的价值[J]. 中华老年心脑血管病杂志, 2015,17(8): 895-896.
[12] 戚瑞祥, 游向东. 二维斑点追踪技术在心血管疾病中的临床应用[J]. 医学影像学杂志, 2016, 26(3): 534-537.
[13] CUSPIDI C, TADIC M, SALA C, et al. How to identify hypertensive patients at high cardiovascular risk? The role of echocardiography[J]. High Blood Press Cardiovasc Prev, 2015, 22(2): 113-117.
[14] VOGT S, KARATOLIOS K, WITTEK A, et al. Detailed measurement of wall strain with 3D speckle tracking in the aortic root: A Case of Bionic Support for Clinical Decision Making[J]. Thorac Cardiovasc Surg Rep, 2016,5(1): 77-80.
[15] PLUTA A, PAWEL SK M, et al. Left ventricular remodeling and arterial remodeling in patients with chronic kidney disease stage 1-3[J]. Renal Fail, 2015, 37(7): 1105-1110.
[16] KIM K H, PARK J C, YOON H J, et al. Usefulness of aortic strain analysis by velocity vector imaging as a new echocardiographic measure of arterial stiffness[J]. J Am Soc Echocardior,2009,22(12): 1382-1388.
[17] MONTEIR O, TEIXEIRA R, RICARD O, et al. Circumferential vascular strain rate to estimate vascular load in aortic stenosis: a speckle tracking echocardiography study[J]. Int J Cardiovasc Imaging,2015,31(4): 681-689.