论文部分内容阅读
背景原发性高血压(EH)左心室肥厚(LVH)的形成机制尚未完全阐明,目前国内外对EH伴LVH与血管内皮依赖性血流介导的舒张功能(FMD)间关系的研究较少,且结果不一致。目的探讨EH伴LVH患者FMD的改变,并初步分析FMD与LVH的关系。方法入选222例轻中度EH患者(包括未降压治疗和已接受降压治疗的患者),根据左心室质量指数(LVMI)≥125(男)或≥110g/m2(女)分为LVH组(n=98)与非LVH组(n=124)。选择同期在我院门诊初诊(未服用任何药物)的非高血压患者40例作为对照组。采用超声心动图法测定LVMI。采用高分辨超声技术测定反应性充血前后肱动脉内径的变化率,作为肱动脉血流介导的舒张功能(FMD)。结果LVH组的FMD[(5.7±2.1)%]显著低于非LVH组[(6.9±2.0)%]和对照组[(10.8±1.9)%,P<0.01]。已接受降压治疗的LVH患者的FMD[(5.9±2.1)%]与未治疗的LVH患者[(5.3±2.1)%]比较无显著差异(P>0.05)。已接受降压治疗的非LVH患者的FMD[(7.2±1.9)%]显著高于未治疗的非LVH患者[(6.3±2.2)%,P<0.05]。相关回归分析显示年龄是EH患者(伴或不伴LVH)FMD共同的影响因素(P<0.05);在LVH患者中,LVMI与FMD呈负相关(r=-0.28,b=-0.06,R2=0.26,P<0.01),而在非LVH患者中二者无相关(r=-0.11,P=0.247)。结论EH伴LVH患者的FMD明显受损,可能需要加大治疗力度才能有效地改善EH伴LVH患者的FMD。
BackgroundThe mechanism of the formation of left ventricular hypertrophy (LVH) in patients with essential hypertension (EH) has not yet been fully elucidated. At present, there are few studies on the relationship between EH with LVH and endothelium-dependent diastolic function (FMD) , And the results are inconsistent. Objective To investigate the changes of FMD in patients with EH accompanied by LVH and to analyze the relationship between FMD and LVH. Methods Totally 222 patients with mild-to-moderate EH (including those without antihypertensive treatment and those who had received antihypertensive treatment) were enrolled and divided into LVH group according to LVMI ≥125 (male) or ≥110g / m2 (female) (n = 98) and non-LVH group (n = 124). Select the same period in our hospital outpatient (no medication) of non-hypertensive patients 40 cases as a control group. LVMI was measured by echocardiography. High-resolution ultrasound was used to measure the rate of change of the brachial artery diameter before and after reactive hyperemia as a brachial artery-mediated diastolic function (FMD). Results The FMD [(5.7 ± 2.1)%] in LVH group was significantly lower than that in non-LVH group [(6.9 ± 2.0)%] and control group (10.8 ± 1.9)%, P <0.01. There was no significant difference (P> 0.05) between FMD [(5.9 ± 2.1)%] and untreated patients with LVH [(5.3 ± 2.1)%] in patients with LVH. FMD [(7.2 ± 1.9)%] in non-LVH patients who received antihypertensive treatment was significantly higher than that in untreated non-LVH patients (6.3 ± 2.2)%, P <0.05. Correlation analysis showed that age was the common influencing factor of FMD in EH patients (with or without LVH) (P <0.05); LVMI was negatively correlated with FMD in patients with LVH (r = -0.28, b = -0.06, R2 = 0.26, P <0.01), but not in non-LVH patients (r = -0.11, P = 0.247). Conclusion EH with LVH in patients with FMD was significantly impaired, may need to step up treatment to effectively improve the EH with LVH in patients with FMD.