原发性高血压左室向心性重构时超声背向散射变化的研究

目的　探讨超声背向散射技术能否反映原发性高血压 (EH)左室向心性重构 (CCR)时组织结构的变化。方法　正常对照组 (CON) 31例 ,利用二维心脏超声测量EH患者左室几何形态参数 ,依据相对室壁厚度 (RWT)和心肌重量指数 (LVMI)筛选出EH左室向心性重构 (CCR) 2 2例 ,利用超声背向散射技术测量左室心肌不同切面的声学密度的变化。结果　四腔切面室间隔 (IVSA)标化的平均声学密度 (IB % )较正常显著增高 ,而胸骨旁长轴室间隔 (IVSL)、后壁 (PWL)、四腔侧壁 (LWA)IB %较正常无显著差异。CCR组胸骨旁长轴、四腔切面各室壁声学密度之和IB % IVSL+IB % PWL+IB % IVSA +IB % LWA 较正常显著增高 (P <0 .0 5 )。两组间背向散射积分周期变异幅度(CVIB)均无显著差异。结论　原发性高血压左室向心性重构时心肌声学密度已有变化。

A study on the changes on integrated backscatter due to left ventricular concentric remodeling in essential hypertension

Objective This study was undertaken to investigate the changes in left ventricular myocardial integrated backscatter (IB) during left ventricular concentric remodeling (CCR) due to essential hypertension (EH), and to study if the IB changes could reflect the degree of histologic changes in the left remodeling. Methods 22 patients with EH and 31 healthy volunteers were involved in the study. The patients were selected cases of EH with the left ventricular CCR determined by using two-diemensional echocardiography according to their relative wall thickness (RWT) and left ventricular mass index (LVMI). The parameters of myocardial IB (acustic density) of the patients were measured and analysed by referring to those of the control. Results In CCR group, the IB% was higher in IVSA; the sum of (IB%IVSL+IB%PWL+IB%IVSA+IB%LWA) was also increased accordingly. CVIB showed no differences in the two groups. Conclusion The changes of myocardial acoustic density would occur in the early stage of left ventricular remodeling.