1.Baotou Medical College Second Affiliated Hospital;2.Inner Mongolia Medical University
目的 通过分析原发性高血压患者左心室收缩末期最大心肌劲度、最大弹性模量与E/A值的相关性，本研究旨在表明左室收缩末期最大心肌劲度和最大弹性模量是舒张性心衰发生的生物力学机制。方法 选取2018年1月—2018年11月在包头医学院第二附属医院门诊、住院部298例原发性高血压患者作为研究对象，另选取健康管理中心体检诊断的115名健康人选入对照组。对入选者进行超声心动图诊断，通过分析分组测值输入公式得出的最大心肌劲度和最大弹性模量与E/A值之间的相关性。结果 （1）五组研究对象maxEav、Emax与E/A值的相关性分析：①LVEH组maxEav与E/A值呈显著负相关（r=-0.417，P<0.01）。②LVCH组maxEav与E/A值呈显著负相关（r=-0.366，P<0.05）；LVCH组Emax与E/A值呈显著负相关（r=-0.491，P<0.01）③LVCR组maxEav与E/A值呈显著负相关（r=-0.404，P<0.01）；LVCR组maxEav与E/A值呈显著负相关（ ）。（2）LVCR组、LVCH组与对照组间的E/A值比较差异显著，具有统计学意义（P<0.05），其余组间E/A值没有明显差异，不具有统计学意义（P>0.05）。LVEH组的maxEav、Emax与E/A的比较与其他组相比，显著增大，差异有统计学意义（P<0.05）。（3）与对照组相比，高血压各组maxEav、Emax均减小，差异统计学表现为P<0.05，差异显著，具有统计学意义。结论 分析maxEav、Emax是判断左室舒张功能更为敏感且简便易得的指标，同时分析高血压左室重构合并舒张功能异常患者心肌最大心肌劲度的变化，探索舒张性心衰的发病机制，可以为今后预防及治疗舒张性心衰提供理论依据。
Objective In terms of the relations among maxEav、Emax and E/A value in patients with essential hypertension, the study is suppose to explore the maxEav and Emax is is direct biomechanical indexes for evaluating myocardial diastolic function，and biomechanical mechanism of diastolic heart failure. Methods (1) 298 patients with essential hypertension were selected as the research object in the Second affiliated hospital of baotou medical college . The groups were examined by conventional three-dimensional echocardiography. The difference was statistically significant. Results (1) Correlation analysis between maxEav,Emax and E/A value of the five groups①The maxEav of the LVCH group was significantly negatively correlated with the E/A value (r=- 0.417, P< 0.01).②The maxEav and E/A value of the LVCH group were significantly negatively correlated (r=-0.366, P<0.05),the Emax of the LVCH group was significantly negatively correlated with the E/A value (r=- 0.491, P<0.01).③The maxEav was significantly negatively correlated with E/A value in the LVCR group (r=-0.404, P<0.01),the Emax and E/A value in the LVCH group Significant negative correlation (r=-0.235,P<0.05).(2) The difference of E/A value between LVCR group, LVCH group and control group was P<0.05, the difference was statistically significant, and the difference of E/A value between the other groups was P>0.05. The maxEav,Emax and E/A of the eccentric hypertrophy group were significantly increased compared with the other groups, the difference was statistically significant (P<0.05); (3) Compared with the control group, The maxEav and Emax of each group of hypertension decreased, and the difference was statistically significant (P<0.05). The difference was statistically significant. Conclusion Analysis of maxEav and Emax is a more sensitive and simple index for judging left ventricular diastolic function. Simultaneous analysis of changes in myocardial maxEav,Emax in patients with left ventricular remodeling and diastolic dysfunction The pathogenesis of diastolic heart failure provides a theoretical basis for the prevention and treatment of diastolic heart failure in the future.