高血压大动脉扩张性与左室结构和功能变化的临床研究  

Clinical Study Of Relationship Between Large Arterial Distensibility \;and Left Ventricular Structure and Function In Hypertension

作　　者：王宏宇[1] 李志明[1] 张维忠[1] 龚兰生[1] 邱慧丽[1] 范明昌[1] 吴美枝[1] 

机构地区：[1]上海第二医科大学附属瑞金医院上海市高血压研究所,上海心功能室200025

出　　处：《高血压杂志》1999年第3期209-212,共4页Chinese Journal of Hypertension

摘　　要：评估高血压发展过程中大动脉扩张性与左室结构和功能的改变；观察影响这些变化的临床因素；分析高血压时大动脉变化 与心脏变化间的内在联系。　方法：分别应用脉搏波速度测量仪和彩色多普勒及二维超声心动图对颈动脉－ 股动脉脉搏波传导速度（ Ｐｕｌｓｅ ｗ ａｖｅ ｖｅｌｏｃｉｔｙ， Ｐ Ｗ Ｖ）和左室结构及功能变化进行观察。　结果：总体分析所有高血压患者 Ｐ Ｗ Ｖ 增高（１１．３±２．３ｍ ／ｓ），左室重量指数（ Ｌ Ｖ Ｍ Ｉ９９．９±３１．４ ｇ／ｍ ２ ）正常，射血分数（ Ｅ Ｆ０．６７±０．０８）正常，舒张早期二尖瓣峰值速度（ Ｐ Ｅ）与舒张晚期二尖瓣峰值速度（ Ｐ Ａ） 比值降低（０．９７±０．３）。多元逐步回归分析结果显示： Ｐ Ｗ Ｖ与收缩压（ Ｓ Ｂ Ｐ），年龄（ａｇｅ）， Ｐ Ａ关系密切（ Ｐ值分别为０．０００１，０．２３７１，０．００１６）； Ｐ Ｗ Ｖ 的改变与 Ｌ Ｖ Ｍ Ｉ密切相关（ Ｐ＝ ０．１９８３）。结论：高血压时会出现大动脉扩张性的降低，这种改变与左室结构变化密切相关。收缩压水平、年龄、左室舒张功能状态是与大动脉扩张性关系最为密切的因素。Aim:To investigate the changes of large arteries ,left ventricular structure and function during hypertension; explore the clinical factors that influence these changes; analyze the relationship between the changes of large artery and the alteration of heart.\ Methods:Pulse wave velocity(PWV) measement ,color doppler and two dimensional echocardiography were used to study carotid femoral PWV and left ventricular structure and function.\ Results:PWV in hypertensive patients were higher(11.3±2.3 m/s),left ventricle mass index(LVMI) were in normal range(99.9±31.4 g/m 2),ejection fraction were normal(0.67±0.08),ratio of peak early mitral diastolic velocity(PE) and peak late mitral diastolic velocity(PA) were lower(0.97±0.3). Mutiple stepwise regression analysis demonstrated systolic blood pressure(SBP, P =0.0001), age( P =0.2371), PA ( P =0.0016) were main factors that influence PWV ,the change of PWV was closely related to LVMI.\ Conclusion:Large arterial distensibility decreased during hypertension,which was closely related to the change of left ventricular structure. The change of large arterial distensibility had close relationship with SBP level,age and left ventricular diastolic function.

关 键 词：高血压 大动脉扩张性 左室肥厚 脉搏波速度 

分 类 号：R544.102[医药卫生—心血管疾病]