原发性高血压患者左心室功能的临床研究

目的探讨原发性高血压患者左心室功能的临床研究。方法原发性高血压患者176例,按Ganau法分为4型:正常构型组(A组)46例、向心性重构组(B组)53例、向心性肥厚组(C组)40例、离心性肥厚组(D组)37例;正常对照组35例。超声心动图测量舒张末室间隔厚度(IVS)、左心室后壁厚度(LVPW)及左心室舒张末期内径,二尖瓣血流频谱左心室舒张早期血流峰速(E),舒张晚期血流峰速(A)值比,左心室射血分数(LVEF)及Tei指数。各组血浆脑钠肽(BNP)浓度对比分析。结果正常对照组与高血压各组比较,在年龄、性别均差异无显著性意义,C组、D组收缩压最高,左心房内径最大(P<0.05);B组、D组IVS、LVPW轻度增厚(P<0.05);高血压各组的E/A值均降低(P<0.05),LVEF值只有D组与正常对照组比较差异有显著性意义;各组Tei指数差异有显著性意义;BNP在B组、C组、D组差异有显著性意义。结论Tei指数,BNP共同评价原发性高血压患者不同左心室构型的心功能情况,对原发性高血压的治疗效果和预后有临床应用价值。

Clinical study on left ventricular function in patients with essential hypertension

Objective To explore left ventricular function in patients with essential hypertension.Methods 176 patients with essential hypertension were divided into four groups: normal left ventricle(group A,46 cases),concentric remodeling(group B,53 cases),concentric hypertrophy(group C,40 cases) and eccentric hypertrophy(group D,37 cases),and 35 normal subjects served as the control group.The conventional echo-Doppler parameters assessed included:left atrial diameter(LA),left ventricular end-diastolic diameter(LVDd),interventricular septal end-diastolic thickness(IVS),left ventricular posterior wall thickness(LVPW),left ventricular mass index(LVMI),relative wass thickness(RWT),E/A ratio,ejection fraction(LVEF) and Tei index.Results Compared with the control group,in groups C and D,the systolic pressures were higher and LA was larger.In groups B and D,IVS,LVPW were slightly thickened.E/A in all hypertension groups was decreased(P<0.05).The LVEF was significantly reduced in group D(P<0.05).Tei index in all hypertension groups was prolonged.The plasma concentration of BNP in groups B,C and D significantly raised.Conclusions Tei index and BNP were valuable and easy to estimate left ventricular systolic and diastolic functions with high sensitivity.