高血压合并餐后高血糖对左室结构影响的观察

目的探讨高血压合并早期糖代谢异常对心脏结构的影响。方法选取2级高血压病患者90例,其中2 h PG正常的2级高血压患者51例为单纯高血压组;2 h PG血糖增高的2级高血压患者39例为观察组,同时选取性别、年龄相匹配的健康体检者30例作为健康对照组,均测定2 h PG、BP,采用心脏超声测量舒张末期室间隔厚度(IVST)、左室后壁厚度(LVPWT)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)。计算左室质量(LVM)和相对室壁厚度(RWT)。分析比较各组的2 h PG和左室结构变化。结果观察组患者的2 h PG和BMI明显高于其他2组(P<0.01)。观察组和单纯高血压组患者的IVST、LVPWT、LVM、LVMI水平均明显高于健康对照组(P<0.01)。观察组患者的IVST、LVPWT、LVM、LVMI水平均高于单纯高血压组(P<0.05)。结论高血压合并2 h PG升高可能加速和加重左心室重构,早期糖代谢异常可能是影响高血压左室重构的危险因素。

Clinical observation on left ventricular structure of hypertension with high postprandial blood glucose

Objective To investigate the effects of the left ventricular structure in the patients with hypertension and early glycol-metabolism disorder. Methods A total of 90 hypertension patients in stage II and 30 controls were observed, the hypertension subjects were divided into two groups according to 2hPG： essential hypertension（ n = 51 ） and hypertension with hyperglycemia（ n = 39）. 2h postprandial blood glucose （2h PG）, blood pressure （ BP ）, inter-ventricular septum thickness （IVST）, left ventrieular posterior wall thickness （LVPWT）, left ventricular end diastolic diameter （LVEDD）, left ventricu- lar end systolic diameter （LVESD） were measured. Left ventricular mass （ LVM ） and relative wall thickness （RWT） were calculated based on these parameters. 2hPG and left ventrieular structure were compared in each group. Results In 90 cases of grade two hypertension, the incidence of glucose metabolism abnormality was 43.33 % （ n = 39）. Compared with other two groups, 2hPG and body mass index （BMI） in hypertension with hyperglycemia group were sigpificantly higher, and the result had statistical difference（ P 〈 0.01 ）. IVST, LVPWT, LVM and left ventricular mass index （LVMI） in essential hypertension group and hypertension with hyperglycemia group were obviously higher than that in the controls （ P 〈 0.01 ）. IVST, LVPWT, LVM and LVMI in hypertension with hyperglycemia group were higher than that in the essential hypertension group （ P 〈 0.05 ）, but there had no statistical differences. Conclusion Hypertension always complicated with glucose metabolism abnormality. Hypertension with hyperglycemia might accelerate and aggravate left ventricular remodeling. Early period of abnormal glycol-metabolism might be an important risk factor which affected left ventricular structure in hypertension cases.