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目的:应用彩色M型多普勒超声心动图测量舒张早期左室内血流传播速度(Vp),评价高血压(EH)患者左室舒张功能,以寻求一种可靠客观的评价高血压左室舒张功能的方法。方法:采用放免法测定19例正常人和41例EH患者(伴心肌肥厚者19例和不伴心肌肥厚者22例)的血清Ⅰ型前胶原(PCⅠ)和Ⅲ型前胶原(PCⅢ)的浓度,用彩色M型多普勒超声心动图测量左室内血流传播速度(Vp),并用血流多普勒法检测二尖瓣口舒张期血流速度E峰、A峰及E/A值,比较两种方法测值与PCⅠ、PCⅢ的相关性。结果:1.EH患者非左室肥厚组(non-LVH)与左室肥厚组(LVH)PCⅠ、PCⅢ明显高于正常对照组(P<0.01),其中LVH组PCⅠ明显高于non-LVH组(P<0.05)。2.EH患者非左室肥厚组(non-lVH)与左室肥厚组(LVH)二尖瓣血流参数,Vp均明显低于正常对照组(P<0.05)。3.EH患者non-LVH组与LVH组间E、E/A无明显差别(P>0.05),但LVH组Vp明显低于non-LVH组(P<0.05)。4.EH患者non-LVH组血清PCⅠ、PCⅢ与E/A及Vp均呈负相关(r=-0.58P<0.01,r=-0.61P<0.01及r=-0.67P<0.01,r=-0.51P<0.05);而LVH组血清PCⅠ、PCⅢ与Vp亦呈负相关(r=-0.69P<0.05,r=-0.65P<0.01);与E/A无明显相关(r=-0.41P>0.05,r=0.02P>0.05)。结论:左室内血流传播速度与反应心肌纤维化程度的血清PCⅠ、PCⅢ浓度相关良好,不受心脏负荷及年龄的影响,作为评价高血压病人左室舒张功能的指标有临床意义。
OBJECTIVE: To evaluate left ventricular diastolic velocity (Vp) in early diastole by color M-mode Doppler echocardiography and to evaluate left ventricular diastolic function in patients with hypertension (EH) in order to find a reliable and objective evaluation of left ventricular diastolic function Function method. Methods: The serum concentrations of type Ⅰ procollagen (PCⅠ) and type Ⅲ procollagen (PCⅢ) in 19 normal subjects and 41 patients with EH (19 patients with myocardial hypertrophy and 22 patients without myocardial hypertrophy) were determined by radioimmunoassay , The left ventricular blood flow velocity (Vp) was measured by color M-mode Doppler echocardiography, and the E-peak, A-peak and E / A of diastolic velocities of mitral valve were measured by flow Doppler, The correlation between the two methods and PCⅠ, PCⅢ was compared. PCⅠ and PCⅢ in non-LVH group and LVH group were significantly higher than those in normal control group (P <0.01), and PCⅠ in LVH group was significantly higher than that in non-LVH group (P <0.05). The mitral flow parameters and Vp in non-LVH group and LVH group were significantly lower than those in normal control group (P <0.05). There was no significant difference between EH group and LVH group (P> 0.05). However, Vp in LVH group was significantly lower than that in non-LVH group (P <0.05). There was a negative correlation between serum PCⅠand PCⅢ and E / A and Vp in non-LVH group (r = -0.58P <0.01, r = -0.61P <0.01 and r = -0.67P <0.01, r = 0.51P <0.05). However, there was a negative correlation between serum PCⅠ, PCⅢ and Vp in LVH group (r = -0.69P <0.05, r = -0.65P <0.01) > 0.05, r = 0.02P> 0.05). Conclusion: The velocity of left ventricular blood flow is related to the concentration of serum PCⅠ and PCⅢ in response to myocardial fibrosis, which is independent of cardiac load and age. It is of clinical significance to evaluate left ventricular diastolic function in hypertensive patients.