超声观察原发性高血压患者左室肥厚与冠脉内皮功能障碍的关系  

Left Ventricular Hypertrophy and Coronary Endothelial Dysfunction in Essential Hypertension

作　　者：张平洋[1] 邓又斌[2] 杨好意[2] 毕小军[2] 潘敏[2] 

机构地区：[1]南京医科大学附属南京第一医院心血管超声科,江苏南京210001 [2]华中科技大学同济医学院附属同济医院超声影像科,湖北武汉430000

出　　处：《高血压杂志》2005年第7期411-414,共4页Chinese Journal of Hypertension

基　　金：国家自然基金资助课题(项目号.30270560)

摘　　要：目的探讨原发性高血压(EH)左室肥厚(LVH)与冠脉内皮功能障碍之间的关系。方法超声观察34例EH患者和15例正常人的心脏结构及功能,此后研究受检者含服硝酸甘油所致的血管非内皮依赖性扩张性(DING),并结合冷加压超声心动图试验评价其冠状动脉内皮依赖性扩张性(DICPT)。结果与正常组(14.98%±1.54%)相比,非LVH(15/34)和LVH(19/34)患者的冠状动脉内皮依赖性扩张性(9.18%±1.12%;4.27%±2.01%)均显著减小,且后者较前者更甚(P<0.001)。LVH组患者的左室重量指数(LVMI)(159.6±29.6)g/m2较非LVH组(98.8±12.8)g/m2及正常组(113.1±13.1)g/m2增大(P<0.001)。LVH组、非LVH组的血压均较正常组增高,但前两组间的血压无显著性差异。3组间的冠脉非内皮依赖性扩张性、EF、FS及年龄、血脂、血糖等无显著性差异(P>0.05)。相关分析显示:患者的左室重量指数与冠状动脉内皮依赖性扩张性呈良好负相关(r=-0.54,P<0.0001)。结论原发性高血压患者左室肥厚与冠脉血管内皮功能障碍密切相关,后者可能在左室肥厚的发生发展过程起作用。Objective To investigate the relationship between left ventricular hypertrophy and coronary endothelial dysfunction in essential hypertension. Methods We studied 34 patients with hypertension and 15 healthy subjects using echocardiography. The diameter of left main coronary artery was detected before and after cold pressure test (DICPT)or nitroglycerin (DING) using echocardiography with probe located on the beginning of left main coronary artery. Results Compared with the normal control (14.98%±1.54%), the coronary artery dilatation induced by cold pressure test was lower both in patients without left hypertrophy(9.18%±1.12%, n=5)and with left hypertrophy (4.27%±2.01%, n=19) with remarkable difference between them(P<0.01). The left ventricular mass index (LVMI)was higher in patients with left ventricular hypertrophy(LVH)(159.6±29.6)g/m 2 than that without left ventricular hypertrophy(98.8±12.8)g/m 2 and that in the normal(113.1±13.1)g/m 2(P<0.001). No significant difference in blood pressure between the two hypertensive groups[(155.4±4.8/95.5±6.5 vs 154.4±4.6/98.2±4.4)mm Hg, P>0.05] was found. LVMI correlated negatively with the coronary artery dilatation induced by cold pressure test (r=-0.54,P<0.000 1). Conclusion Left ventricular hypertrophy was associated with coronary endothelial dysfunction in essential hypertension. The coronary endothelial dysfunction may contribute to the development of left ventricular hypertrophy.=

关 键 词：超声 原发性高血压 左室肥厚 冠脉内皮功能障碍 

分 类 号：R541.3[医药卫生—心血管疾病]