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目的探讨高血压患者左心房内径(LAD)变化及其相关因素。方法选择上海市虹口区欧阳社区高血压健康促进俱乐部成员作为调研对象,经社区公告通知,自愿参加者中高血压人群2 000例,非高血压人群500例。测量或记录受试者的体质量、身高、血压、患高血压时间、降压治疗时间、糖尿病和心律失常情况;心电图分析心房颤动(房颤)情况;心脏超声分析LAD、左心室内径(LVEDD)、室间隔厚度(IVS)、左心室壁厚度(LVPW)及射血分数(EF)指标。Spearman秩相关检验分析LAD的相关因素。结果共入组高血压组人群1 605例,其中男性671例,女性934例;入组非高血压组人群432例,其中男性85例,女性347例。高血压组与非高血压组人群的LAD、LVEDD和EF值比较差异均有统计学意义(P<0.05),但IVS和LVPW比较差异均无统计学意义(P>0.05)。在高血压组,LAD的增大与患者年龄、体质量指数(BMI)、收缩压以及伴有糖尿病、房颤有明显相关性(P<0.05);但与患高血压时间、降压药物治疗时间无明显相关性(P>0.05);LAD的变化与性别也无明显相关性(P>0.05)。结论高血压人群LAD的变化与患者的年龄、BMI、收缩压、伴有糖尿病或房颤有明确的相关性,在社区对相关的危险因素进行干预可减少LAD增大和房颤的发生。
Objective To investigate the changes of left atrial diameter (LAD) and its related factors in hypertensive patients. Methods The members of the Ouyang Community Hypertension Health Promotion Club in Hongkou District of Shanghai were selected as the research objects. According to community notice, there were 2 000 middle-high blood pressure volunteers and 500 non-hypertensive ones in the volunteer participants. The body mass, height, blood pressure, time to hypertension, antihypertensive treatment time, diabetes and arrhythmia were measured or recorded. The atrial fibrillation (ECG) was analyzed by electrocardiogram. The left ventricular diameter (LVEDD) ), Interventricular septum thickness (IVS), left ventricular wall thickness (LVPW) and ejection fraction (EF). Spearman rank correlation test analyzes the related factors of LAD. Results A total of 1 605 hypertensive patients were enrolled, including 671 males and 934 females. There were 432 males and 85 females in the non-hypertensive group. There were significant differences in LAD, LVEDD and EF between hypertensive group and non-hypertensive group (P <0.05), but there was no significant difference between IVS and LVPW (P> 0.05). In hypertensive group, the increase of LAD was significantly associated with age, body mass index (BMI), systolic blood pressure and diabetes mellitus and atrial fibrillation (P <0.05) There was no significant correlation between time and LAD (P> 0.05). There was no significant correlation between LAD and gender (P> 0.05). Conclusions There is a clear correlation between LAD changes and the age, BMI, systolic blood pressure, diabetes or atrial fibrillation in hypertensive population. Intervention in community with related risk factors can reduce the increase of LAD and the occurrence of atrial fibrillation.