心脏超声在高血压左心室肥厚伴左心力衰竭患者中的诊断价值

目的探讨心脏超声在高血压左心室肥厚伴左心力衰竭患者中的诊断价值。方法选择2017年2月至2019年2月我院收治的50例高血压左心室肥厚伴左心力衰竭患者为研究组,另选取同期来院接受常规体检的健康自愿者50例为对照组。两组均接受心脏超声检查。比较两组的心脏功能指标、心脏变异率指标以及研究组不同心功能分级患者的心脏功能指标。结果研究组的左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、二尖瓣舒张期最大血流速度与二尖瓣环舒张早期最大运动速度的比值(E/Ea)均高于对照组,左室射血分数(LVEF)低于对照组(P<0.05)。研究组的全部窦性心搏R-R间期的标准差(SDNN)、相邻R-R间期差值均方根(RMSSD)、相邻窦性R-R间期差值50 ms所占百分比(PNN50)均低于对照组(P<0.05)。随着心功能分级水平的升高,患者的LVEDD、LVESD、E/Ea均升高,而LVEF降低,不同心功能分级患者间比较,差异有统计学意义(P<0.05);心功能Ⅱ、Ⅲ级患者的LVEDD、LVESD、E/Ea均高于心功能Ⅰ级患者,LVEF均低于心功能Ⅰ级患者(P<0.05)。结论结合高血压左心室肥厚伴左心力衰竭患者的疾病特点,应用心脏超声检查方法有助于临床诊断病情,评估患者心功能状态,从而为临床治疗方案的制定提供有效参考依据,值得临床推广应用。

Value of echocardiography in the diagnosis of hypertensive left ventricular hypertrophy with left heart failure

Objective To investigate the value of echocardiography in the diagnosis of hypertensive left ventricular hypertrophy with left heart failure. Methods From February 2017 to February 2019, 50 patients with hypertensive left ventricular hypertrophy with left heart failure admitted in our hospital were selected as study group, another 50 healthy volunteers who received regular physical examination in the same period were selected as control group. Both groups received echocardiography. The cardiac function indexes and cardiac variability indexes of the two groups and the cardiac function indexes of patients with different cardiac function grades in the study group were compared. Results The left ventricular end diastolic dimension(LVEDD), left ventricular end systolic diameter(LVESD) and ratio of the maximum diastolic velocity of the mitral valve to the maximum early diastolic velocity of the mitral annulus(E/Ea) in the study group were higher than those in the control group, and left ventricular ejection fractions(LVEF) was lower than that in the control group(P<0.05). The standard diviation of NN intervals(SDNN), the mean square root of adjacent RR interval difference(RMSSD), the percentage of adjacent sinus R-R interval 50 ms(PNN50) in the study group were lower than those in the control group(P <0.05). The LVEDD, LVESD and E/Ea of patients increased with the increase of the cardiac function grades, while the LVEF decreased, and the differences were statistically significant among patients with different cardiac function grades(P<0.05);the LVEDD, LVESD and E/Ea of patients with grade Ⅱ and grade Ⅲ of cardiac function were higher than those of patients with grade Ⅰ of cardiac function, and LVEF were lower than those of patients with grade Ⅰof cardiac function(P <0.05). Conclusion Assisted by the disease characteristics of patients with hypertensive left ventricular hypertrophy and left heart failure, the application of echocardiography is helpful for clinical diagnosis and evaluation of patients’ cardiac function, so as to provide an effective reference for the formulation of clinical treatment plan,which is worthy of clinical application and promotion.