原发性高血压患者左心房扩大及其影响因素

目的　分析 12 0例原发性高血压患者左心房大小及其影响因素。方法　原发性高血压患者 12 0例 ,男 5 9例 ,女 6 1例 ,年龄 33～ 78岁。全部患者分为两组 ,年龄≥ 6 0岁为老年组 (6 0例 ) ,年龄 <6 0岁为非老年组 (6 0例 )。每组根据心脏超声分为左心室肥厚和无左心室肥厚两个亚组。左心房内径大于 4cm为左心房扩大 ,面积 长度法左心室重量指数男性 >89g m2 ,女性 >77g m2 为左心室肥厚。结果　非老年组 4 3%、老年组 73%合并左心室肥厚 ;非老年组 14例 (2 3% )、老年组 2 2例 (37% )合并左心房扩大 ;37%患者左心房扩大和左心室肥厚同时并存 ,2 0 %患者仅有左心房扩大 ;两组左心房扩大者共 36例 ,其中老年组合并左心室肥厚占 5 0 % (18 36 ) ,非老年组合并左心室肥厚占 2 2 % (8 36 ) ;多因素分析提示超重、血压水平与左心房扩大无显著相关性 ,年龄和左心室重量指数同左心房扩大显著相关。结论　年龄与左心室肥厚是原发性高血压左心房扩大的重要影响因素。

Factors affecting left atrial enlargement in hypertension

Objective To evaluate the factors affecting left artrial (LA)size in hypertensive patients. Methods120 hypertensive patients consisting of 59 males and 61 females aged from 33～78 years were studied. The diameter of LA larger than 4 cm was defined as LA enlargement. Left ventricular mass index higher than 89 g/m2(male)or 77 g/m2(female)was defined as left ventricular hypertrophy. The patients were divided by age into 2 groups(<60 and ≥60 years).Results Left ventricular hypertrophy(LVH) was present in 43% of patients aged <60 years and in 73% of patients aged ≥60 years. Left atrial enlargement was present in 37% of elderly and in 23% of younger patients, and in 37% of patients with and 20% of patients without LVH.The older age group with left ventricular hypertrophy contained 50% of all patients with LA enlargement,while the younger age group contained only 22%.Multivariate analysis showed that left atrial englargement was not correlated with overweight or level of blood pressure; but had notable correlation with age or LVH.Conclusion Age or LVH is the important factor affecting left atrial size in hypertensive patients.