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目的应用64层螺旋CT对原发性高血压病心功能进行评估,探讨其主要CT表现。方法高血压病例127例,按世界卫生组织高血压诊断标准将其分为高血压Ⅰ、Ⅱ、Ⅲ级组。正常对照组21人。均行多层螺旋CT心脏成像扫描,经心脏分析软件包处理后分别计算出体表面积、左室射血分数、左室舒张末期容积、左室收缩末期容积、每搏输出量、心指数、左室心肌质量等参数,并进行统计学分析。结果高血压病Ⅰ级组46例主要为心肌肥厚改变(P<0.05),高血压病Ⅱ级组38例逐步出现心肌几何构形重构,高血压Ⅲ级组43例心脏离心性重构,心功能减低,左室舒张及收缩末期容积升高,射血分数、每搏输出量、每分输出量、心指数均减低(各组均P<0.05)。结论原发性高血压病心脏改变是从向心性重构到离心性重构,从心功能代偿到失代偿动态过程;64层CT可全面客观评价原发性高血压病心脏功能。
Objective To evaluate the cardiac function of patients with essential hypertension by using 64-slice spiral CT and to explore its main CT features. Methods A total of 127 cases of hypertension were divided into hypertension Ⅰ, Ⅱ and Ⅲ groups according to WHO diagnostic criteria of hypertension. Normal control group of 21 people. All patients underwent multi-slice spiral CT cardiac imaging scanning. After treatment by heart analysis software package, the body surface area, left ventricular ejection fraction, left ventricular end-diastolic volume, left ventricular end-systolic volume, stroke volume, cardiac index Ventricular mass and other parameters, and statistical analysis. Results Hypertensive patients in grade Ⅰ group (46 cases) were mainly cardiac hypertrophy (p <0.05), myocardial hypertrophy in grade Ⅱ group (38 cases) and cardiac remodeling in 43 cases (grade Ⅲ) Cardiac function decreased, left ventricular diastolic and end systolic volume increased, ejection fraction, stroke volume, output per minute, cardiac index decreased (all P <0.05). Conclusion The cardiac changes of essential hypertension are from concentric remodeling to centrifugal remodeling, from the decompensation of heart function to the decompensation dynamic process. The 64-slice CT can evaluate the cardiac function of patients with essential hypertension in a comprehensive and objective way.