高血压前期人群左心室结构和功能的改变:盲法评估及对照组比较  

Changes of left ventricular structure and function in the population with prehypertension:blind evaluation and controlled trial

作　　者：陈广胜[1] 李新立[1] 许迪[1] 吴成权[1] 王震震[1] 廖静[1] 

机构地区：[1]南京医科大学第一附属医院心内科,江苏省南京市210029

出　　处：《中国临床康复》2005年第15期80-81,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:左室重量、心血管病事件的危险性及进展与高血压的风险性有肯定的相关性,探讨一组高血压前期人群左心室结构和功能变化的特征。方法:本项目于2004-04/07在南京医科大学附属第一医院体检中心和心内科完成。纳入标准:年龄40～70岁、血压<140/90mmHg(1mmHg=0.133kPa),既往未服用过影响血压药物的健康人群,均知情同意。符合以上纳入标准者共80例,按美国预防、检测、评估与治疗高血压联合委员会第七次报告分为正常血压组和高血压前期组。其中正常血压组40人,男29人,女11人,年龄41～70岁;高血压前期组40人,男27人,女13人,年龄40～70岁。采用彩色多普勒超声诊断仪监测左心室各结构和功能参数;并计算左室重量指数、平均室壁厚度、相对室壁厚度及左室室壁中层缩短率。结果:进入结果分析正常血压组和高血压前期组分别为40人。高血压前期组左室重量指数、平均室壁厚度、相对室壁厚度(93±16)g/m2,(8.9±0.8)mm,(0.38±0.04)较正常血压组增高(84±13)g/m2,(8.3±0.7)mm,(0.35±0.03)(t=3.21～4.25,P<0.01),左室室壁中层缩短率较正常血压组降低(17.8±1.4)%,(18.9±1.5)%,(t=4.16,P<0.01)。在血压水平正常范围内,平均动脉压与左室重量指数、平均室壁厚度、相对室壁厚度呈正相关。AIM: The risk of hypertension has certain correlations with left ventricular mass and the risk and progress of cardiovascular events.This paper aims to investigate the changing characteristics of left ventricular structure and function in a group of prehypertensive subjects. METHODS:The study was carried out in the physical examination center and cardiological department of the First Affiliated Hospital of Nanjing Medical University from April to July 2004.Inclusion criteria: at 40 to 70 years of age, blood pressure< 140/90 mm Hg, healthy subjects who had never taken any drug that could affect blood pressure, and they all knew and agreed to participate in the study. Eighty subjects were in accordance with the above inclusion criteria, and tey were divided into normotensive group (n=40, 29 males and 11 females, aged 41 to 70 years old) and prehypertension group (n=40, 27 males and 13 females, aged 40 to 70 years old) according to the seventh report of American Joint National Committee on prevention,detection, evaluation, and treatment of high blood pressure (JNC 7).Left ventricular structural and functional indexes were monitered with color Doppler echocardiography, and left ventricular mass index (LVMI),mean wall thickness,relative wall thickness and left ventricular midwall fractional shortening (mFS) were calculated. RESULTS: Forty subjects were involved in the analysis of results both in the normotensive group and prehypertension group respectively. The LVMI, mean wall thickness and relative wall thickness in the prehypertension group [(93±16) g/m2, (8.9±0.8) mm, (0.38±0.04)] were increased as compared with those in the normotensive group [(84±13)g/m2, (8.3 ±0.7) mm, (0.35±0.03)] (t=3.21 to 4.25, P< 0.01).Left ventricular mFS in the prehypertension group [(17.8±1.4)%] was decreased as compared with that in the normotensive group [(18.9±1.5)%](t=4.16, P< 0.01).In normotensive range, mean arterial pressure (MAP) was positively correlated with LVMI (r=0.31,P< 0.05), mean wall thickness (r=0.40,P< 0.01)

关 键 词：高血压前期 结构和功能 室壁中层缩短率 彩色多普勒超声诊断仪 对照组 左室重量指数 相对室壁厚度 正常血压 盲法 心血管病事件 附属第一医院 南京医科大学 心肌收缩功能 纳入标准 左心室结构 联合委员会 平均动脉压 70岁 

分 类 号：R544.1[医药卫生—心血管疾病] R341[医药卫生—内科学]