高血压患者左心室结构与运动耐量的相关性研究  

The correlation between left ventricular structure and exercise tolerance of patients with essential hypertension

作　　者：李莉[1] 严静[1] 龚仕金[1] 宁钢民[2] 余海燕[1] 杨桂秋[2] 任寅姿[2] 戴海文[1] 陈进[1] 蔡国龙[1] 徐强宏[1] 

机构地区：[1]浙江医院重症监护室,杭州310031 [2]浙江大学生物医学工程与仪器科学学院,杭州310031

出　　处：《解放军医学杂志》2011年第1期64-67,共4页Medical Journal of Chinese People's Liberation Army

基　　金：浙江省科技厅重大项目(2006C13018);浙江省人事厅留学回国人员科技活动择优资助项目(2003-001);浙江省老年医学重点学科群招标项目(2009ZB005)

摘　　要：目的探讨高血压患者左心室结构与运动耐量的关系。方法 2008年2月-2010年2月连续收集在浙江医院心血管病门诊就诊的339例原发性高血压患者,其中男226例,女113例。所有患者均行超声心动图检查评价左室结构参数并测定6min步行距离和运动峰耗氧量,根据左室重量指数(LVMI)将患者分为高血压伴左室肥厚(LVH)组(n=145)及高血压不伴LVH组(n=194)。采用简单相关和多元逐步回归分析探讨左室结构参数——左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、舒张末期室间隔厚度(IVST)、左室后壁厚度(PWT)和LVMI与6min步行距离及运动峰耗氧量的相关性。结果单因素相关分析显示,LVEDD(r=-0.157,P=0.004)、LVESD(r=-0.139,P=0.01)、IVST(r=-0.193,P<0.001)、LVMI(r=-0.229,P<0.001)与6min步行距离呈显著负相关,而PWT(r=-0.123,P=0.02)、IVST(r=-0.134,P=0.02)、LVMI(r=-0.182,P<0.001)与峰耗氧量呈显著负相关。多元逐步回归分析显示,LVMI分别是6min步行距离(R2=0.04,P=0.002)和运动峰耗氧量(R2=0.026,P<0.001)的独立影响因素。高血压伴LVH组患者的6min步行距离、运动峰耗氧量(分别为435.1±7.64m、15.9±0.44ml·min-1·kg-1)与高血压不伴LVH组(分别为477.4±6.64m、18.0±0.38ml·min-1·kg-1)比较均显著降低(P<0.001)。结论高血压患者左室结构与运动耐量显著相关,LVMI是运动耐量的独立危险因素。Objective To investigate the correlation between the structure of the left ventricle and exercise tolerance of patient with essential hypertension.Methods The clinical data of 339 hypertensive patients（226 males and 113 females） were consecutively collected from Feb.2008 to Feb.2010 in cardiovascular clinic of Zhejiang Hospital.All the patients underwent Doppler echocardiography in order to appraise the left ventricular structure,and walking tolerance was assessed by 6-minute walk distance test.During each test,peak oxygen consumption（VO2） was measured using a portable metabolic system.The patients were divided into two groups according to left ventricular mass index（LVMI）,hypertension with left ventricular hypertrophy（LVH）（n=145） and hypertension without LVH（n=194）.Unadjusted correlation analysis and stepwise multiple regression analysis were used to investigate the correlation between the left ventricular structure,e.g.left ventricular end diastolic dimension（LVEDD）,left ventricular end systolic dimension（LVESD）,interventricular septal thickness（IVST） and posterior wall thickness（PWT）,LVMI,and 6-minute walk distance and peak VO2.Results Unadjusted correlation analysis showed that LVEDD（r=-0.157,P=0.004）,LVESD（r=-0.139,P=0.01）,IVST（r=-0.193,P〈0.001） and LVMI（r=-0.229,P〈0.001） were negatively correlated with the 6-minute walk distance.PWT（r=-0.123,P=0.02）,IVST（r=-0.134,P=0.02）,and LVMI（r=-0.182,P〈0.001） were negatively correlated to peak VO2.Stepwise multiple regression analysis showed that the LVMI was an independent determinant for both 6-minute walk distance（R2=0.04,P=0.002） and peak VO2（R2=0.026,P〈0.001）.Both 6-minute walk distance and peak VO2 decreased in hypertensive patients with LVH [（435.1±7.64m and 15.9±0.44ml/（min·kg）] compared with that of hypertensive patients without LVH [477.4±6.64m and 18.0±0.38ml/（min·kg）]（P〈0.001）.Conclusions Left ventricular structure is significantly associated with exerc

关 键 词：高血压 左室重量指数 运动耐量 

分 类 号：R541.3[医药卫生—心血管疾病]