不同海拔地区H型高血压患者左室收缩功能及踝臂指数研究

目的探讨不同海拔H型高血压患者（HP）左室收缩功能及踝臂指数的变化特征。方法对不同海拔高血压患者根据血浆同型半胱氨酸（Hcy）水平进行分组，测定各组左心室收缩功能（LVEF）、踝臂指数（ABI）及血清脑钠肽（BNP）。并对上述结果行相关研究、分析。结果（1）低海拔组HP患者BNP水平为374．56±215．67，显著低于高海拔组HP患者543．85±231．52，P〈0．001；低海拔HP患者LVEF为0．47±0．11，显著高于高海拔组0．43±0．10，P〈0．005；低海拔ABI为0．91±0．17，显著高于高海拔组0．84±0．18，P〈0．005。（2）同海拔H型HP组的BNP在低海拔组、高海拔组均显著高于非H型HP组，P〈0．001，LVEF、ABI显著低于非H型高血压组，P〈0．005。高海拔H型HP组BNP显著高于低海拔组P〈0．001，高海拔H型HP组LVEF、ABI显著低于低海拔H型HP组P〈0．05。非H型HP组低海拔与高海拔之间各值均无显著性差异。（3）低海拔、高海拔H型HP组LVSD及ABI异常率均显著高于非H型HP组。高海拔H型HP组LVSD数（88％）显著高于低海拔H型HP组的75％，P〈0．05；高海拔H型组ABI异常率（92％）显著高于低海拔H型组的65％，P〈0．001。而在非H型组中，高、低海拔间LVSD及ABI的异常率均无显著性差异。结论高海拔地区H型高血压患者左室收缩功能不全和踝臂指数异常与高海拔及血浆Hcy水平密切相关。

COMPARISON STUDY OF LEFT VENTRICULAR SYSTOLIC FUNCTION AND ANKLE- BRACHIAL INDEX IN PATIENTS WITH TYPE H HYPERTENSION AT DIFFERENT ALTITUDES

Objective To investigate the Variation characteristics of left ventricular - brachial index in type H hypertensive patients （HP） at different altitudes. Methods were divided into Low -altitude group and High -altitude group according to normal or systolic function and ankle Patients with hypertension elevated plasma homocys teine （Hcy） levels, each group was measured left ventricular systolic function （ LVEF）, ankle - brachial index （ABI） and serum brain natriuretic peptide（BNP）. Results （1）BNP levels in Low -altitude group was 374.56 _±215.67, significantly lower than High - altitude group （543.85 ± 231.52, P 〈 0. 001 ） ;LVEF in Low - altitude group was 0.47 ± 0.11, significantly higher than High -altitude group （0.43 ± 0.10, P 〈 0. 005 ） ;ABI in Low -altitude group was 0.91 _± 0.17, significantly higher than High - altitude group （0.84 ± 0.18, P 〈 0. 005 ）. （2） Both in Low - altitude group and High - altitude group, BNP in type H hypertension group was significantly higher than that of non - type H hypertension group,P 〈 0. 001 ;LVEF,ABI were significantly lower than those of non- type H hypertension group, P 〈 0. 005. High - altitude group with type H hypertension was significantly higher than Low - altitude group in BNP levels,P 〈0. 001 ,and LVEF,ABI were significantly lower,P 〈0.05. There were no significant difference of the value between Low -altitude and High- altitude group with non- type H hypertension. （3）Both in Low- altitude group and High -ahitude group, LVSD and ABI abnormal rate in type H hypertension group were significantly higher than those of non - type H hypertension group. High - altitude group with type H hypertension, LVSD number （88%） was significantly higher than Low- altitude grou.p 75% ,P 〈 0.05 ;High -altitude group with type H hyper- tension, ABI abnormal rate （92%） was significantly higher than Low - altitude group 65 % , P 〈 0. 001. there were no significant differences in rates of LVSD and abnormal ABI between High - altitude group and Low - altitude group with non -type H hypertension. Conclusion Patients with type H hypertension at high altitude are shown left ventricular systolic dysfunction and abnormal ankle - brachial index, which is closely related to the high altitude and plasma Hcy levels.