家族史对原发性高血压患者左室结构及功能的影响  

Echocardiographic evaluation of the effects of family history on left ventricular pattern and function in patients with essential Hypertension

作　　者：张玉东[1] 孙志丹[1] 孔爱丽[2] 王松男[3] 贺欣[1] 

机构地区：[1]辽宁医学院附属一医院心内科,辽宁锦州121001 [2]葫芦岛市中心医院,辽宁葫芦岛125025 [3]锦州市中心医院,辽宁锦州121001

出　　处：《中国现代医学杂志》2011年第14期1637-1640,共4页China Journal of Modern Medicine

摘　　要：目的观察家族史对原发性高血压患者左心结构及功能的影响。方法选择有高血压家族史但血压正常者100例;有高血压家族史伴有高血压者100例,无高血压家族史但高血压者100例,正常对照组100例。分别测量左室舒张末期内径(LVIDed)、室间隔厚度(LVST)、左室后壁厚度(LVPWT),并计算左室重量指数(LVMI)、相对室壁厚度(RWT),测量射血分数(EF)、短轴缩短率(FS)。应用组织多普勒测量二尖瓣环舒张早期峰值速度e(cm/s)及心房收缩期峰值速度a(cm/s),计算e/a的值。再根据LVMI、RWT划分高血压患者左室几何构型,对各几何构型中有家族史及无家族史者的左心结构及功能变化进行分析。结果有高血压家族史但血压正常者LVPWT、LVMI高于正常对照组。有家族史伴高血压者不同构型的LVIDed、LVST、LVPWT均大于无家族史伴高血压者。有家族史伴高血压者舒张功能明显降低,在向心性肥厚型中较为显著。有家族史组收缩功能下降,在离心性肥厚性中较为明显。结论家族史对原发性高血压患者左心结构、功能具有一定影响,在向心性肥厚及离心性肥厚型中表现明显。且LVPWT、LVMI在高血压发生之前就已发生改变。【Objective】 To evaluate the effects of family history on left ventricular pattern and function in patients with essential hypertension using echocardiographic.【Methods】 400 people were enrolled in this study including 200 essential hypertensive patients（100 with positive family history） and 200 normotensive offsprings（100 subjects with positive family history,FH＋）.The left ventricular end-diastolic internal diameter（LVIDed）,interventricular septal thickness（IVST）,left ventricular posterior wall thickness（LVPWT）,ejection fraction were detected by echocardiography.Using DTI to detect early diastolic velocity and late diastolic velocity,different patterns of left ventricular hypertrophy were analyzed according to left ventricular mass index（LVMI） and relative wall thickness（RWT）.【Results】 There were higher LVPWT,LVMI in normotensive offsprings with FH＋than those with no family history（FH-）.Compared with essential hypertensive patients with FH-,LVIDed,IVST and LVPWT were higher in essential hypertensive patients with FH＋.The diastolic function decrease in FH＋,especially in concentric left ventricular hypertrophy,the systolic function decrease in FH＋,especially in eccentric left ventricular hypertrophy.【Conclusion】 Hypertensive family history contribute to the patterns of left ventricular hypertrophy,cardiac structure and function.The influence is significant in concentric and eccentric left ventricular hypertrophy.

关 键 词：家族史 高血压 左心功能 超声心动描计术 

分 类 号：R544.1[医药卫生—心血管疾病]