三维斑点追踪技术评价阻塞型睡眠呼吸暂停低通气综合征伴高血压患者左心室整体收缩功能

目的 应用三维斑点追踪（3D-STI）技术评价阻塞型睡眠呼吸暂停低通气综合征（OSAHS）伴高血压（HT）患者左心室整体收缩功能。方法 OSAHS 40例，分为单纯OSAHS组20例和OSAHS+HT组20例；另选择20名健康正常人作为正常对照组。行常规超声心动图检查，采集左心室心尖四腔三维全容积图像，存储图像并应用3D-STI分析软件在线分析，计算左心室整体纵向收缩峰值应变（GLS）、左心室整体径向收缩峰值应变（GRS）、左心室整体圆周收缩峰值应变（GCS）及左心室整体面积收缩峰值应变（GAS）。结果 与正常对照组相比，OSAHS组 左心室GLS、GRS、GAS减低（P均<0.05），OSAHS+HT组左心室GLS、GRS、GCS、GAS均减低（P均<0.05）。与OSAHS组比较，OSAHS+HT组 左心室GLS、GCS、GAS均减低（P均<0.05）。结论 OSAHS合并HT患者存在左心室收缩功能受损。3D-STI能早期、准确有效地评估其左心室整体收缩功能改变。OSAHS患者心脏结构及功能变化独立于HT而单独存在，二者同时存在时改变加重。

Three-dimensional speckle tracking echocardiography in evaluation on left ventricular global systolic function in obstructive sleep apnea hypopnea syndrome patients with hypertension

Objective To evaluate the left ventricular (LV) global systolic function with three-dimensional speckle tracking echocardiography (3D-STI) in obstructive sleep apnea hypopnea syndrome (OSAHS) patients with hypertension (HT). Methods Totally 40 patients with OSAHS were divided into simple OSAHS group (n=20) and OSAHS with HT group (n=20). In addition, 20 healthy people were set as the control group. All subjects were examined with echocardiography to obtain 3D apical four-chamber images. 3D-STI software was applied to acquire the LV global longitudinal peak systolic strain (GLS), global radial peak systolic strain (GRS), global circumferential peak systolic strain (GCS) and global area peak systolic strain (GAS). Results Compared with control group, LV GLS, GRS, GAS reduced in OSAHS group (P<0.05), while GLS, GRS, GCS and GAS reduced in OSAHS with HT group (P<0.05). Compared with those in OSAHS group, GLS, GCS, GAS were lower in OSAHS with HT group (P<0.05). Conclusion 3D-STI can identify early functional LV changes in OSAHS patients with HT. Changes of cardiac structure and function of OSAHS patients are independent of the presence of HT, though HT aggravates the structure and function abnormalities of LV in patients with OSAHS.