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目的探讨超声心动图评价H型高血压患者心功能情况的临床价值,并分析影响H型高血压患者心功能的相关因素。方法抽取2013年10月至2016年11月秦皇岛市第一医院诊治的94例高血压患者,根据血清同型半胱氨酸(Hcy)水平分为H型组(Hcy≥10μmol/L)与非H型组(Hcy<10μmol/L),各47例。另选同期体检血压、心电图正常的健康者47例设为对照组。对所有研究对象年龄、性别、身高、体质量、抽烟史等一般资料进行收集记录,于入院后行超声心动图检查,并抽取空腹静脉血,检测Hcy、血脂[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白-胆固醇(LDL-C)、高密度脂蛋白-胆固醇(HDL-C)]、血糖[空腹血糖(FBG)、糖化血红蛋白(Hb Alc)]、B型利钠肽(BNP)、超敏C反应蛋白(hs-CRP)等实验室指标水平。对比三组心脏结构[左室舒张末期内径(LVDd)、左房收缩末期前后径(LAD)、左室收缩末期内径(LVDs)、舒张末期室间隔厚度(LVST)、左室后壁厚度(LVPWTd)]、舒张功能[E/A、S/D、Em/Am、E/Em]和收缩功能[左室射血分数(LVEF)、Tei指数]。结果 (1)心脏结构:H型组、非H型组LVDd、LAD、LVDs、LVST及LVPWTd与对照组比较差异无统计学意义(P均>0.05),且H型组、非H型组各指标组间比较差异无统计学意义(P均>0.05);(2)心脏功能:H型组与非H型组E/A、S/D、Em/Am及LVEF均低于对照组,E/Em、Tei指数高于对照组,差异有统计学意义(P<0.05,P<0.01),且H型组E/A、S/D、Em/Am低于非H型组,E/Em、Tei指数高于非H型组,差异有统计学意义(P<0.05,P<0.01);(3)相关因素:年龄、肥胖、血糖、血脂、Hcy、BNP及hs-CRP水平、抽烟史均是H型高血压患者心功能的影响因素(P均<0.05)。结论超声心动图可对H型高血压患者心功能作出准确评价,且H型高血压患者舒张功能与收缩功能均存在不同程度改变,其中年龄、肥胖、血糖、血脂、Hcy、BNP及hs-CRP水平、抽烟史均是其重要影响因素。
Objective To investigate the clinical value of echocardiography in assessing cardiac function in patients with Hypertension and analyze the related factors influencing cardiac function in patients with Hypertension. Methods Totally 94 hypertensive patients diagnosed and treated in the First Hospital of Qinhuangdao from October 2013 to November 2016 were divided into H group (Hcy≥10μmol / L) and non-H (Hcy) according to the level of serum homocysteine (Hcy) (Hcy <10μmol / L), 47 cases in each group. Another examination of the same period physical examination of blood pressure, ECG normal healthy 47 cases as a control group. The data of all subjects including age, sex, height, body weight and smoking history were collected and recorded. Echocardiography was performed after admission and fasting venous blood was collected for detection of Hcy, total cholesterol (TC), triglyceride TG, HDL-C, HDL-C, FBG, HbA, B-type natriuretic peptide Peptide (BNP), high-sensitivity C-reactive protein (hs-CRP) and other laboratory indicators. The left ventricular end-diastolic diameter (LVDd), left ventricular end-diastolic anteroposterior diameter (LAD), left ventricular end-systolic diameter (LVDs), end diastolic ventricular septal thickness (LVST), left ventricular posterior wall thickness (LVPWTd )], Diastolic function [E / A, S / D, Em / Am, E / Em] and systolic function [LVEF, Tei index]. Results (1) The cardiac structure: There was no significant difference in LVDd, LAD, LVDs, LVST and LVPWTd between H group and non H group (P> 0.05) (2) Cardiac function: E / A, S / D, Em / Am and LVEF in H group and non H group were lower than those in control group, and E / Em and Tei index were significantly higher than those in the control group (P <0.05, P <0.01), and the E / A, S / D and Em / (P <0.05, P <0.01); (3) The related factors: age, obesity, blood glucose, blood lipid, Hcy, BNP and hs-CRP levels, smoking history Hypertension patients with heart function are the influencing factors (all P <0.05). Conclusions Echocardiography can accurately evaluate the cardiac function in patients with Hypertension. The diastolic function and systolic function of patients with Hypertension have varying degrees of change, including age, obesity, blood glucose, blood lipids, Hcy, BNP and hs-CRP Level, smoking history are all important factors.