老年人脉压与左心室肥厚构型及心功能的关系  

Correlation of Pulse Pressure and Patterns of Left Ventricular Hypertrophy and Cardiac Function in Old Patients with Hypertension

作　　者：王路宏[1] 杜毅鹏[1] 王秀红[1] 

机构地区：[1]北京中医药大学附属护国寺中医院老年病房,北京市100035

出　　处：《中国全科医学》2008年第1期16-17,20,共3页Chinese General Practice

摘　　要：目的探讨经药物规则治疗的老年高血压病(EH)患者的脉压(PP)与左心室肥厚(LVH)构型及心功能间的关系。方法回顾性分析176例有或无LVH的老年EH患者的PP与LVH构型及心功能的相关性。结果(1)不对称性室间隔肥厚(ASH)、对称性室间隔肥厚(CH)及扩张性肥厚(DH)组患者的PP与无LVH组间差别有统计学意义(P均<0.01);(2)随着PP增大,左心室收缩及舒张功能均明显降低;(3)Logistic回归分析显示,PP与老年EH患者左心功能不全的发生存在明显的相关性,PP每增加10 mmHg,左心功能不全增加30%,其OR的95%CI(1.23,1.37),P<0.0001;在对年龄和EH病程进行校正后显示,PP每增加10 mmHg左心功能不全发生率增加19%,其OR的95%CI(1.13,1.25),P<0.0001。结论在药物规则治疗的老年EH患者中,PP与LVH构型具有一定的联系,PP是左心功能不全发生的一个重要和独立的相关因素,且随着PP增大,左心室收缩及舒张功能均明显降低。Objective To investigate the relationship between pulse pressure （PP） and patterns of left ventricular hypertrophy （LVH） and cardiac function in hypertensive old - aged patients who had been received standard antihypertensive therapy. Methods The correlation of blood pressure with LVH was analyzed retrospectively in 176 old - aged patients with essential hypertension. Results （1） There＇was significant difference in PP between the patients with asymmetric septal hypertrophy, symmetric septal hypertrophy and dilated hypertrophy and shoes with no LVH （ P 〈0.01 ）. （2） The cardiac systolic and diastolic functions were decreased with rise of PP. （3） Logistic regression analysis showed that PP was strongly correlated with left cardiac insufficiency in old - aged patients with essential hypertensive. Every 10 mmHg increment in PP was associated with 30% increase in left cardiac insufficiency risk 95% CI （ 1.23 - 1.37 ）, P 〈 0. 0001. After adjusting for age and duration of hypertension, every 10 mmHg increment in PP was associated with 19% increase in left cardiac insufficiency risk 95%CI： 1.13 tol. 25, P 〈 0. 0001. Conclusion The PP has a positive correlation with patterns of LVH and may be an independent and important risk factor for left cardiac insufficiency in essential hypertensive old - aged patients under standard antihypertensive therapy. The cardiac systolic and diastolic functions were decreased with rise of PP.

关 键 词：高血压 老年人 血压测定 肥大 左心室 

分 类 号：R544.1[医药卫生—心血管疾病] R541.3[医药卫生—内科学]