高血压患者左心房内径变化及其相关因素

目的 探讨高血压患者左心房内径(LAD)变化及其相关因素.方法 选择上海市虹口区欧阳社区高血压健康促进俱乐部成员作为调研对象,经社区公告通知,自愿参加者中高血压人群2000例,非高血压人群500例.测量或记录受试者的体质量、身高、血压、患高血压时间、降压治疗时间、糖尿病和心律失常情况；心电图分析心房颤动(房颤)情况；心脏超声分析LAD、左心室内径(LVEDD)、室间隔厚度(IVS)、左心室壁厚度(LVPW)及射血分数(EF)指标.Spearman秩相关检验分析LAD的相关因素.结果 共入组高血压组人群1 605例,其中男性671例,女性934例；入组非高血压组人群432例,其中男性85例,女性347例.高血压组与非高血压组人群的LAD、LVEDD和EF值比较差异均有统计学意义(P＜0.05),但IVS和LVPW比较差异均无统计学意义(P＞0.05).在高血压组,LAD的增大与患者年龄、体质最指数(BMI)、收缩压以及伴有糖尿病、房颤有明显相关性(P＜0.05)；但与患高血压时间、降压药物治疗时间无明显相关性(P＞0.05)；LAD的变化与性别也无明显相关性(P＞0.05).结论高血压人群LAD的变化与患者的年龄、BMI、收缩压、伴有糖尿病或房颤有明确的相关性,在社区对相关的危险因素进行干预可减少LAD增大和房颤的发生.

Change of left atrial diameter and its related clinical factors in patients with hypertension

Objective To investigate the change of left atrial diameter(LAD) and its related clinical factors in patients with hypertension.Methods Two thousand patients with hypertension and 500 people without hypertension were selected from Ouyang Community of Hongkou District in Shanghai.The body weight,height,blood pressure,duration of hypertension,duration of anti-hypertension treatment and conditions of diabetes mellitus and arrhythmia were measured or recorded.The incidence of atrial fibrillation was analysed with electrocardiogram,and the parameters of LAD,left ventricular end-diastolic diameter(LVEDD),interventricular septal thickness(IVS),left ventricular wall thickness(LVPW) and ejection fraction(EF) were analysed with echocardiography.The related clinical factors of LAD were explored by Spearman rank test.Results There were 1 605 patients in hypertension group,with 671 males and 934 females.There were 432 people in non-hypertension group,with 85 males and 347 females.There were significant differences in LAD,LVEDD and EF between hypertension group and non-hypertension group(P<0.05),while there was no significant difference in IVS and LVPW between two groups(P>0.05).In hypertension group,the increase of LAD was significantly associated with age,body mass index,systolic blood pressure and conditions of diabetes mellitus and atrial fibrillation(P<0.05),while was not significantly associated with duration of hypertension and duration of anti-hypertension treatment(P>0.05),and the change of LAD was not significantly related to sex(P>0.05).Conclusion LAD is related to age,body mass index,systolic blood pressure and conditions of diabetes mellitus and atrial fibrillation in patients with hypertension.Community intervention on risk factors may decrease the LAD increase and incidence of atrial fibrillation.