原发性高血压患者左心室构型与冠状动脉内皮功能障碍间关系的超声研究  

Study on relationship between left ventricular geometry and coronary endothelial dysfunction in essential hypertension by ultrasonography

作　　者：张平洋[1] 邓又斌[1] 杨好意[1] 毕小军[1] 潘敏[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院超声影像科

出　　处：《中华超声影像学杂志》2005年第3期184-187,共4页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金资助项目(30270560)

摘　　要：目的　了解原发性高血压患者左心室构型与冠状动脉内皮功能障碍之间的关系。方法　超声观察 34例原发性高血压患者和 15例正常人的心脏结构和功能,随后运用冷加压超声心动图试验结合含服硝酸甘油所致的血管内径变化分别评价冠状动脉内皮依赖性扩张(DICPT)和非内皮依赖性扩张(DING)。结果　①左室正常构型组、向心性重构组的DICPT[(8. 19±1. 74)%, (8. 60±2. 37)% ]较正常对照组[(14. 98±1. 54)% ]显著减小(P<0. 001),而前两组间差异无显著性意义。三组间的DING差异无显著性意义。②与左室正常构型组、向心性重构组相比,左室向心性肥厚组、离心性肥厚组的DICPT[(3. 32±1. 76)%, (2. 86±0. 48)% ]显著减小,且离心性肥厚组较向心性肥厚组更加显著(P<0. 001)。③与左室正常构型组、向心性重构组、向心性肥厚组相比,左室离心性肥厚组患者的左室射血分数和左室短轴缩短率显著减小(P<0. 001),但前 3组与正常对照组间左室射血分数、左室短轴缩短率差异无显著性意义。④不同左室构型组血压较正常对照组显著增高(P<0. 001),但年龄、血糖、血胆固醇及血甘油三脂与正常对照组间的差异无显著性意义。⑤DICPT与左室质量指数、左室相对室壁厚度、左室射血分数、左室短轴缩短率呈负相关(r=-0. 54,P<0. 0001; -0.Objective To study the relationship between left ventricular geometry and coronary endothelial dysfunction in essential hypertension.Methods Thirty-four patients with hypertension and 15 healthy subjects were examined by echocardiography firstly, and then their coronary artery dilatation induced by cold pressure test (DICPT)or nitroglycerin (DING)respectively was investigated.Results ①The DICPT both in the patients with normal left geometry [((8.19)±(1.74))%] and in the patients with concentric remodeling [((8.60)±(2.37))%] were lower than that in the normal[((14.98)±(1.54))% ,P<(0.001)].There was no significant difference in DING between the patients of three groups and in DICPT between the patients with normal left geometry and in the patients with concentric remodeling(P>(0.05)).②DICPT in the patients with concentric hypertrophy [((3.32)±(1.76))%] or eccentric hypertrophy [((2.86)±(0.48))%] was lower than that in the patients with normal left geometry or concentric remodeling.The DICPT was lowest in the patients with concentric hypertrophy(P<(0.001)).③Left ventricular ejection fraction(EF) and fractional shortening(FS) in patients with eccentric hypertrophy was lower than those in the patients of other three groups although there was no significant difference in EF and FS between patients with various left ventricular pattern and the control.④The blood pressure in the patients was higher than that in the normal even though there was no significantly difference in blood pressure between the patients of four groups(P>(0.05)).There were no significant differences in age,serum concentrations of total cholesterol or triglyceride or sugar and DING between the patients with different left ventricular pattern and the normal(P>(0.05)).⑤ Analysis showed that DICPT correlated well with the left ventricular mass index,relative wall thickness of left ventricular,EF and FS(r=(-0.54),P<(0.0001);r=(-0.24),(-0.30);(-0.33),P<(0.05),respectively).Conclusions Left ventricular geometry was related with coronary

关 键 词：左室 正常 原发性高血压患者 对照组 冠状动脉内皮功能 向心性肥厚 向心性重构 短轴 构型 离心 

分 类 号：R445.1[医药卫生—影像医学与核医学]