老年原发性高血压患者左心房/左心室容量比值的变化

目的本文旨在探讨老年原发性高血压患者左心房容量／左心室容量比值变化的临床意义。方法老年正常对照组32例。老年原发性高血压无室壁肥厚患者35例，老年原发性高血压患者伴室壁肥厚者33例。应用实时三维三平面显像方式测量左房、左室容量，对3组病人的左房容量，左房内径，左房容量指数和左心房容量／左心室容量比值进行分析。结果左房容量，左房内径，左房容量指数和左心房容量／左心室容量比值在高血压室壁肥厚组与对照组之间均存在极显著差异（P〈0．01），但左房内径在原发高血压无室壁肥厚组与对照组之间无显著差异（P〉0．05）。左房容量、左房容量指数在原发高血压无室壁肥厚组与对照组之间差异有显著性（P〈0．05），左心房容量／左心室容量比值在原发高血压无室壁肥厚组与对照组之间差异更为显著（P〈0．01）且变异性最小。结论左心房容量／左心室容量比值是一种新的参数，能够灵敏地反映老年原发性高血压患者舒张功能减低的血流动力学改变。

Alternation of ratio of left atrial-ventricular volume in elderlv patients with essential hypertension

Objective To investigate the alternation of ratio of left atrial-ventricular volume in old patients with essential hypertension. Methods Sixty-eight elderly essential hypertensive patients and thirty-two control subjects were studied. According to the wall thickness of left ventricle, the elderly patients with essential hypertension were divided into group with normal wall thickness of left ventricle and group with hypertrophic wall of left ventricle. Volume of left atrium and left ventricle （LAV ,LVV） were measured in mode of real-time three dimension and three plane imaging. LAV, left atrial diameter （LAD）, volume index of left atrium （LAVi）, and the ratio of left atrial - ventricular volume （LAV/LVV） were compared among the three groups. Results Compared with the control, LAV, LAD ,LAVi and LAV/LAA were increased significantly in patients with hypertrophic wall of left ventricle（P 〈0. 01）, but the difference in LAD between patients with hypertension with normal wall thickness of left ventricle and control group was not significant（P〉0.05）. The differences in LAV and LAVi were significant between the hypertensive patients with normal wall of left ventricle and the control （P〈0.05）. LAV/LVV was increased significantly（P〈0.01） in patients with hypertension with normal wall thickness of left ventricle compared with the control group. Conclusion LAV/LVV is a new parameter which reflects sensitively the alternation of the hemodynamics of the decrease in diastolic function of left ventricle in elderly patients with essential hypertension.