摘要
目的 原发性高血压患者多数发生左室重塑 ,本研究探讨无重塑者左房、左室几何形状和左室舒张功能有无变化。方法 顺序门诊或住院的男性患者 ,排除患有心瓣膜疾病、急性或陈旧性心肌梗死、扩张性心肌病及其他影响心脏结构疾病者及年龄小于 3 5岁者。进行超声心动图检查 ,测量室间隔 (IVST)、左室后壁厚度 (LVPWT)和舒张末期横径 (LVEDD)、左房前后径、长径、横径和面积、左室舒张早期二尖瓣峰值血流速度 (EPV)和舒张晚期二尖瓣峰值血流速度 (APV) ,计算后两者的比值 (EPV/APV)、左室质量指数 (LVMI)和相对室壁厚离 (RWT)。LVMI≥ 13 1g/m2 或 /和RWT≥ 0 44者不能进入本研究。余下的原发性高血压者进入无左室重塑原发性高血压组 (简称无重塑组 ) ,无原发性高血压者进入正常对照组 (简称对照组 )。组间比较行 t检验。结果 对照组共14 6例男性入选 ,15 6例男性原发性高血压患者入选无重塑组。无重塑组无论是IVST、LVPWT、LVEDD、LVMI及左房前后径、长径、横径和面积均大于对照组 (P <0 0 1) ,无重塑组EPV/APV比值明显小于对照组 (P <0 0 1) ,两组EPV无明显差异 ,APV差异明显 (P<0 0 1。结论 与正常对照组者比较 ,无左室重塑的原发性高血压男性患者左房扩大。
Objective To investigate whether the geometry of the left heart and the diastolic function of left ventricle change in patients with essential hypertension but without left ventricular remodeling. Methods Echocardiography was performed in consecutive male patients above 35 years old and without valvular heart disease, myocardial infarction, cardiomyopathy or other diseases that may have effect on the heart structure. The thickness of intra-ventricular septum(IVST) and left ventricular posterior wall (LVPWT), the end-diastolic diameter of the left ventricle(LVEDD), left atrial anterior-posterior(LAAPD), long (LALD) and cross-sectional diameters(LACD) and area(LAA), early diastolic peak velocity(EPV) and atrial contraction peak velocity(APV) of the mitral valve flow were measured. EPV/APV ratio, left ventricular mass index(LVMI), relative wall thickness(RWT) were calculated. Patients with LVMI≥131g/m 2 and/or RWT≥0 44 were excluded from this study. The remaining patients were divided into 2 groups: the patients with essential hypertension were included in the no-remodeling group(group NR), while the patients without essential hypertention entered the normal control group (group NC). Student test was used to compare the variables between the two groups. Results There were 146 cases in group NC and 156 in group NR. IVST,LVPWT,LVEDD,LVMI,LAAPD,LALD,LACD and LAA of group NR were larger than those of group NC(P<0 01). EPV/APV ratio of group NR was significantly smaller that that of group NC(P<0 01). There was no significant difference in EPV between the two groups while the difference of APV was statistically significant(P<0 01). Conclusion The left atrium enlarged and the diastolic function of the left ventricle was impaired in male patients with essential hypertension but without remodeling of the left ventricle.
出处
《中国医师杂志》
CAS
2004年第5期620-622,共3页
Journal of Chinese Physician
