左心房增大与高血压关系的研究

目的探讨左心房增大与高血压的关系。方法对50例左心房增大患者（E组）进行血压监测，另对同期30例新发高血压患者（A组）、已确诊高血压但血压未达标的30例患者（B组）、已确诊高血压血压已达标的30例患者（C组）及30名健康对照人群（D组）行心脏超声测定左心房、左心室、室间隔、动态血压检查，化验同型半胱氨酸和尿酸。结果50例左心房增大患者中确诊高血压23例，占46％。左心房增大A、B、C、D组分别为65．4％、68．8％、15．8％和5．3％；左心房大小A、B、C、D组分别为（30．1±5．5）mm、（31．0±4．5）mm、（27．3±5．6）mm和（26．8±6．1）mm。前三组和D组比较，A组与C组比较，B组与C组比较，左心房增大差异有统计学意义（P〈0．05）；而A组与B组比较，左心房增大差异无统计学意义。同型半胱氨酸（HCY）和尿酸（UA）高血压组均比对照组明显升高（P〈0．05），A组、B组、C组间两两比较，差异无统计学意义（P〉0．05）。左心房增大与血压相关，而与年龄、体质量指数、尿酸、同型半胱氨酸无相关性（P〉0．05）。结论左心房增大作为高血压的标记物，结合同型半胱氨酸、尿酸，可识别高血压患者，提高高血压诊断率。

Study of the relationship between hypertension and left atrium enlargement

Objective To explore the relationship of hypertenion and left atrial enlargement. Methods 50 patients with Enlargement of left atrium （group E） were undergone blood monitoring. 120 subjects including 30 cases of patients newly confirmed hypertension（group A）, 30 eases of patients with confirmed hypertension but the blood pressure did not reach target（group B）, 30 cases of patients with established hypertension and targeted blood pressure （grpup C）, 30 cases of the health （group D）, were performed echocardiographic and ambulance blood pressure monitor, and the plasm level of homocysteine, uric acid were measured respectively. Results There were 23 patients with hypertension in the patients with left atrial enlargement, account for 45%. Percentage of patients were 65.4%, 68.8%, 15.8%, 5.3% in the group A, B, C and D, respectively and level of left atrium were （30.1±5.5）mm, （31.0±4.5）mm, （27.3±5.6）mm, （26.8±6.1）mm in the group A,B,C and D respectively. There was significantly difference between A and D, B and D, C and D, A and C, B and C（P〈0.05）, but was no dif-ference between A and B. The levels of HCY and UA in the patients with hypertension were more higher than that of group D. Enlargement of left atrium was close correlated with hypertension, but was no correlate with age, BMI, HCY and UA. Conclusion There is close correlation between hypertension and enlargement of left atrial （P〈 0.05 ）. Enlargement of left atrial is mark of hypertension and combined with HCY, UA, can help to identify and diagnose patients with hypertension.