原发性高血压患者左室构型与外周血管内皮功能障碍之间的关系  

Relationship Between Left Ventricular Geometry and Peripheral Vascular Endothelial Dysfunction in Essential Hypertension

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,武汉市430030

出　　处：《中国超声医学杂志》2005年第4期262-265,共4页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然基金资助课题 (No.30 2 70 560 )

摘　　要：目的　探讨原发性高血压( EH)患者左室构型( L VG)与外周内皮功能障碍之间的关系。方法　超声观察5 5例EH患者和2 0例正常人的心脏结构功能,采用高频超声研究受检者的肱动脉充血后反应性扩张( DIRH)和含服硝酸甘油后血管内径的变化( DING)。结果　( 1 )与正常组( 1 3 .0 9%±3 .3 5 % )相比,左室正常构型组、向心性重构组的DIRH( 8.4 3 %±1 .71 % ;7.94 %±1 .5 7% )均显著减小( P<0 .0 0 1 ) ,而后2组间的DIRH、3组间的DING无显著性差异( P>0 .0 5 ) ;( 2 )左室向心性肥厚组、离心性肥厚组的DIRH ( 3 .2 0 %±1 .72 % ;5 .81 %±1 .72 % )较正常构型组、向心性重构组显著减小,且向心性肥厚组最为显著( P<0 .0 0 1 ) ;( 3 )除左室离心性肥厚组患者的EF( 5 3 .5 5 %±3 .1 2 % )、FS( 3 0 .3 3 %±9.4 % )较正常组( 6 0 .95 %±6 .0 3 % ;3 5 .80 %±5 .72 % )显著减小( P<0 .0 0 1 )外,其余患者EF、FS与正常组间无显著性差异;( 4 )不同左室构型组患者的血压较正常组显著增高,但各组患者之间无显著性差异( P>0 .0 5 )。各组患者的年龄、血糖、血胆固醇及血甘油三脂均与正常组间无显著性差异( P>0 .0 5 )。结论　不同左室构型的EH患者的外周血管内皮功能障碍程度不同。Objective To investigate the relationship between left ventricular geometry and peripheral vascular endothelial dysfunction in essential hypertension.Methods A total of 55 patients with essential hypertension and 20 healthy subjects were studied on echocardiography and their brachial artery dilatation induced by reactive hyperemia(DIRH) or nitroglycerin (DING) were examined respectively on high-resolution ultrasonography.Results (1)Compared with the normal(13.09±3.35%),the DIRH both in the patients with normal left geometry (8.43±1.71%)and in the patients with concentric remodeling(7.94±1.57%)were lower(P<0.001).There was no significantly difference in DING between the patients of the three groups and in DIRH between the patients with normal left geometry and with concentric remodeling(P>0.05).(2)DIRH in the patients with concentric hypertrophy or eccentric hypertrophy (3.20±1.72%;5.81±1.72% )was lower than that in the patients with normal left geometry or concentric remodeling and DIRH was the lowest in the patients with concentric hypertrophy(P<0.001).(3)EF(53.55±3.12%) and FS(30.33±9.4%) in patients with eccentric hypertrophy was lower than those in the normal(60.95±6.03%;35.80±5.72%) while there was no significantly differenc in EF and FS between other patients with various left ventricular patterns and the control.(4)The blood pressure in the patients was higher than that in the control even though there was no significantly difference in blood pressure between the patients with various left ventricular patterns(P>0.05).And there were no significantly differences in age,serum concentrations of total cholesterol or triglyceride or sugar and DING between the patients with different left ventricular patterns and the normal(P>0.05).Conclusions Peripheral endothelial dysfunction varied with the patterns of left ventricular geometry in essential hypertension.The endothelial dysfunction might be one of the basic factor in the development and progression of the left ventricular remodeling.

关 键 词：血管内皮功能障碍 左室构型 原发性高血压患者 外周 显著性差异 向心性重构 向心性肥厚 心脏结构功能 EH患者 正常组 血甘油三脂 超声观察 血管内径 硝酸甘油 超声研究 血胆固醇 正常人 反应性 肱动脉 受检者 

分 类 号：R544.1[医药卫生—心血管疾病] R392.12[医药卫生—内科学]