高血压患者左室不同构型的特点

目的 :观察高血压患者左室不同构型的临床特点。方法 :对 2 2 8例高血压患者进行超声心动图检查 ,6 0例正常人为对照组。结果 :2 2 8例高血压患者中左室正常构型占 2 1.9% ,向心性重构占 36 .4 % ,向心性肥厚占 32 .9% ,离心性肥厚占 8.8%。高血压组主动脉根部内径和左房内径高于对照组 (P <0 .0 5 ) ,以向心性肥厚和离心性肥厚组更为明显 ;离心性肥厚的CI和SVI高于对照组和向心性重构组 (P <0 .0 5 ) ;向心性重构EF和FS值最高 (P <0 .0 5 ) ,离心性肥厚EF值最低 (P <0 .0 5 ) ;高血压组E/A比值均低于对照组 (P <0 .0 5 ) ,尤其是向心性肥厚和离心性肥厚。总外周血管阻力 (TPR)在向心性重构组最高 (P <0 .0 5 ) ,离心性肥厚组最低 (P <0 .0 5 )。结论 :左室不同几何构型有其各自的特点 ,提示应采取不同的治疗措施。

Different patterns of the left ventricle of heart in hypertensive patients

Objective To observe the clinical characteristics of different patterns of the left ventricule of heart in hypertensive patients.Methods Echocardiography was used in 228 essential hypertensive patients and 60 healthy individuals.Results In the hypertensive group, the rate of normal left ventricle, concentric remodeling, concentric hypertrophy and eccentric hypertrophy were 21.9%, 36.4%, 32.9% and 8.8%,respectively. The aortic root dimension and left atrial dimension were higher in the hypertensive group than those in the normal group (P<0.05), especially for concentric hypertrophy and eccentric hypertrophy. Cardiac index and stroke volume index in eccentric hypertrophy were higher than those in the normal group and concentric remodeling (P<0.05). Ejection fraction and fractional shortening in concentric remodeling were the highest and ejection fraction in eccentric hypertrophy was the lowest among all patterns (P<0.05). E/A rate was lower in the hypertensive group than in the normal group (P<0.05), especially for concentric hypertrophy and eccentric hypertrophy. The total peripheral resistance was the highest in concentric remodeling and the lowest in eccentric hypertrophy (P<0.05). Conclusion Different patterns in the left ventricle have their own characteristics and patients should be treated differently according to the patterns.