肾性与原发性高血压患者左心室肥厚及功能变化的比较研究  

The comparative study on left ventricular hypertrophy and function in patients with renal hypertension vs those with essential hypertension

作　　者：刘广建[1] 林晖莉[2] 李月婷[1] 余江水[2] 黄荣桂[1] 

机构地区：[1]福建医科大学附属第二医院肾内科,泉州362000 [2]福建医科大学附属第二医院心内科,泉州362000

出　　处：《临床肾脏病杂志》2009年第6期267-269,共3页Journal Of Clinical Nephrology

摘　　要：目的比较肾性高血压患者和原发性高血压患者左心室肥厚及功能的变化。方法采用超声心动图检查30例肾性高血压患者及20例年龄、性别、血压相匹配的肾功能正常的原发性高血压患者，观察左心室肥厚及重量指数（LVMI）、左心室射血分数（EF）及左心室等容舒张时间（IVRT）和E／A比值。结果30例肾性高血压患者左室肥厚发生率、LVMI、IVRT高于原发性高血压患者，E／A比值低于原发性高血压患者，EF值无显著差异，肾性高血压患者存在明显的钙磷代谢紊乱、继发性甲状旁腺功能亢进症和贫血，其LVMI与血红蛋白呈显著负相关，而与血清全段甲状旁腺激素（iPTH）呈显著正相关。结论肾性高血压患者左心室肥厚程度及左心室舒张功能障碍较原发性高血压患者严重，除高血压外，贫血及继发性甲状旁腺功能亢进亦应受到重视。Objective To compare the changes in hypertrophy and function of left ventricle in patients with renal hypertension（RH） vs those with essential hypertension（EH）. Method Thirty patients with RH and 21） with EH with normal renal function, matched for age, sex and blood pressure, were examined by eehocardiography. Left ventricular hypertrophy（LVH）, left ventricular mass index （LVMI）, ejection fraction （EF）,left ventricular isovolumic relaxation time（IVRT） and E/A ratio were evaluated. Result Incidence of LVH, the LVMI and IVRT in RH patients were higher, but the E/A ratio was lower than in EH patients. There was no significant difference in EF between RH patients and EH patients. Anaemia, disorder of serum calcium and serum phosphate, secondary hyperparathy- roidism （SHPT） appeared in RH patients, and there was a positive correlation between LVMI and changes in serum iPTH （P〈0. 01 ）, and a negative correlation between LVMI and Hb（P〈0. 1）1）. Conelusion The left ventricular hypertrophy and diastolic dysfunction in IRH patients are severer than in EH patients, besides high blood pressure,attention should be paid to anaemia and secondary hyperparathyroidism.

关 键 词：肾衰竭 慢性 高血压 贫血 甲状腺功能亢进症 

分 类 号：R544.1[医药卫生—心血管疾病] R544.14[医药卫生—内科学]