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目的探讨广州市相对健康的中老年人左心室舒张功能减退及其相关危险因素。方法采用单纯随机方法收集390名年龄≥50岁,无脑卒中、心肌梗死、肺心病及恶性肿瘤等重大慢性疾病史的中老年人进行横断面研究,收集其个人资料及病史、体格检查并测定血清空腹血糖、血脂水平;采用彩色多普勒超声诊断仪,进行左心舒张功能指标测定,包括二尖瓣舒张早期血流峰值(E)和舒张晚期血流峰值(A)及E/A,E峰减速时间(DT)和等容舒张时间(IVRT)。结果①A峰随着年龄的增长而增高,E/A随着年龄的增长而减低(均P<0.05)。②调整了年龄和性别之后,随着腰围的增大,A峰和IVRT随之升高,而E/A则随之降低;同时也发现A峰随三酰甘油和空腹血糖水平升高而升高(均P<0.05)。③用三分位数分组,对310名未服用抗高血压药物者的血压水平,调整了年龄和性别,结果显示A峰随收缩压和脉压差升高而增高(P<0.05),而E/A则随收缩压和舒张压的升高而降低(P<0.05)。④理想血压组、正常血压高值组和高血压组的A峰水平呈逐步升高(P<0.05),而E/A则呈逐步下降的趋势(P<0.05)。结论血压升高是左心室舒张功能损伤的独立危险因素,即使血压在正常水平范围内,左心舒张功能仍随血压的升高而减低。
Objective To investigate the left ventricular diastolic dysfunction and its related risk factors in relatively healthy middle-aged and elderly people in Guangzhou. Methods A total of 390 elderly patients aged 50 years or older with no major history of stroke, myocardial infarction, pulmonary heart disease and malignancies were recruited to study the cross-sectional study using a simple randomized method. Personal data and medical history were collected and physical examination was performed. Serum fasting blood glucose and blood lipid levels were measured by color Doppler sonography. The left ventricular diastolic function indexes including mitral early diastolic blood flow peak (E) and late diastolic blood flow peak (A) and E / A, E peak deceleration time (DT) and isovolumic relaxation time (IVRT). Results ① Peak A increased with age, while E / A decreased with age (all P <0.05). ② After adjusting for age and gender, with the increase of waist circumference, the A peak and IVRT increased, while the E / A decreased. At the same time, it was found that peak A increased with the increase of triglyceride and fasting blood glucose High (all P <0.05). Grouping with tertiles, adjusted for age and sex by blood pressure level in 310 non-antihypertensive patients. The results showed that peak A increased with systolic blood pressure and pulse pressure (P <0.05), while E / A decreased with increasing systolic and diastolic blood pressure (P <0.05). (4) The peak A level of the ideal blood pressure group, the normal high blood pressure group and the hypertension group showed a gradual increase (P <0.05), while the E / A decreased gradually (P <0.05). Conclusion High blood pressure is an independent risk factor for left ventricular diastolic dysfunction. Even if the blood pressure is within the normal range, left ventricular diastolic function still decreases with the increase of blood pressure.