农村高血压合并左心室肥厚患者的预后特点  

The Prognostic Characteristics of Hypertensive Left Ventricular Hypertrophy in a Rural Population

作　　者：陈达光[1] 吴可贵[1] 谢良地[1] 陈金水[1] 王耀华[1] 晋学庆[1] 张声[1] 卢声远[1] 史习舜[1] 许能锋[1] 

机构地区：[1]福建医学院附属第一医院,福建医学院高血压研究室,福建医学院流行病学教研室

出　　处：《中国医学科学院学报》1994年第1期29-34,共6页Acta Academiae Medicinae Sinicae

基　　金：国家自然科学基金

摘　　要：对１２６例中国农村高血压合并左心室肥厚（ＨＴ－ＬＶＨ）患者追踪观察１０年，并以年龄、性别、职业和地区相匹配的１６３例单纯高血压（ＨＴ）与２７５例正常人做为非暴露组，进行队列研究。结果发现我国农村ＨＴ－ＬＶＨ患者死亡原因虽以脑卒中居多，但矫正血压因素后，ＬＶＨ本身并非脑卒中独立危险因子，然仍为心血管意外的独立危险因子。ＬＶＨ所以合并脑卒中较多，是由于其血压均值在３组中最高的缘故。矫正血压因素后，心电图单纯左心室高电压的脑卒中与心血管意外危险因素都消失，只有左心室肥厚加劳损才是心血管意外的独立危险因素。建议不必把左心室高电压列为心、脑血管意外的危险因子。在低水平范围内，血胆固醇的高低对脑卒中意外发生率无影响。One hundred and twenty-six rural hypertensive patients with ECG left ventricular hypertrophy(HT-LVH)were followed up for 10 years to investigate the prognostic characteristics in a population with low prevalence of hypertension(2.93%)and low plasma cholesterol (4.59±1.00mmol/L).A cohort of age, sex,region and occupation matched hypertensives without LVH(HT,n=163) and normotensives(NT, n=275)served as controls. The major cause of death in rural hypertensives with ECG LVH in this study was stroke(56.8%). After stratification of BP,no significant difference of stroke risk was found between patients with LVH and hypertensives without LVH , while cardiovascular risk in the patients with LVH plus ST segment depression persisted. LVH per se seems not to be an independent factor for stroke, The high stroke rate in patients with LVH may be ascribed to the coexisting higher level of BP. After adjustment of coexisting hypertension, ECG LVH based on voltage only was not an independent risk factor of stroke and cardiovascular events,while LVH plus ST segment depression was closely related to cardiovascular events.In this low level, plasma cholesterol did not affect the mortality rate of stroke.

关 键 词：高血压 左 心室肥厚 脑卒中 预后 

分 类 号：R544.107[医药卫生—心血管疾病]