老年高血压合并阻塞性睡眠呼吸暂停综合征对左心室重构的影响  

The effect of hypertension with obstructive sleep apnea syndrome on left ventricle remodeling in elderly patients

作　　者：缪京莉[1] 侯晓平[1] 刘颖萍[2] 张龙芳[1] 

机构地区：[1]空军总医院干部病房,北京100142 [2]北京世纪坛医院

出　　处：《中国临床保健杂志》2011年第5期449-451,共3页Chinese Journal of Clinical Healthcare

摘　　要：目的观察老年高血压(HT)合并阻塞性睡眠呼吸暂停综合征(OSAS)对左心室重构的影响。方法选择56例老年患者,根据睡眠和动态血压监测,分为HT合并OSAS组21例,单纯HT组17例,无HT,也无OSAS为对照组18例,全部对象接受多普勒超声心动图检查。各组间比较舒张末期左心室间隔厚度(IVST)、左心室后壁厚度(LVPW)、左心室内径(LVDd),左心室质量(LVM)、左心室质量指数(LVMI)、相对室壁厚度(RWT)、左室射血分数(EF)、左心室结构。结果 HT合并OSAS组的IVST、LVPW、LVM>单纯HT组(P<0.05,P<0.01),>对照组(P<0.05,P<0.01);HT合并OSAS组的LVDd、LVMI、RWT>对照组(P<0.05,P<0.01);HT合并OSAS组的EF<对照组(P<0.05);单纯HT组的IVST、LVPW、LVMI、RWT>对照组(P<0.05,P<0.01);HT合并OSAS组的左室肥厚>单纯HT组(P<0.05)、>对照组(P<0.01);左心室正常构型在HT合并OSAS组为0例、单纯HT组4例、对照组9例;HT合并OSAS组的向心性肥厚例数>单纯HT组(P<0.05)、>对照组(P<0.01)。结论老年高血压合并OSAS患者更容易发生左心室肥厚,主要为向心性肥厚。Objective To observe effects of hypertension with obstructive sleep apnea syndrome （OSAS）on left ventricle remodeling in elderly patients. Methods 56 patients were divided into three subgroups according to monitoring sleep and 24h ambulatory blood pressure,21 patients in the subgroup with hypertension and OSAS, 17 patients in the subgroup of simple hypertension,and 18 patients in the subgroup without both hypertension and OSAS. All patients were examined with Doppler echocardiography. The interventricular septum thickness （IVST）, the left ventricular posterior wall thickness （ LVPW ） and the left ventricular dimension （ LVDd ） in end-diastole, left ventricular mass （LVM） ,left ventricular mass index （ LVMI）, relative wall thickness （ RWT）, ejection fraction （ EF）, left ventricular structure were compared among the subgroups. Results IVST, LVPW, LVM in the subgroup of hypertension with OSAS were greater than those in the subgroup of simple hypertension（ P 〈 0.05 ）, and greater than those in the control subgroup（P 〈 0.05）. LVDd, LVMI, RWT in the subgroup of hypertension with OSAS were greater than those in the control subgroup（P 〈 0.05）. EF in the subgroup hypertension with OSAS was less than that in the control subgroup （ P 〈 0.05 ）. IVST, LVPW, LVMI, RWT in the subgroup of simple hypertension were greater than those in the control subgroup（ P 〈 0.05 ） ,left ventricular hypertrophy in the subgroup of hypertension with OSAS was thicker than that in the subgroup of simple hypertension （ P 〈 0.05 ）, and significantly thicker than that in the control subgroup （ P 〈 0. 01 ）. There was no patient of left ventricular normal structure in the subgroup of hypertension with OSAS, but 4 patients in the subgroup of simple hypertension, and 9 patients in the control subgroup. The patients with concentric myo-cardial hypertrophy in the subgroup of hypertension with OSAS was more than those in the subgroup of simple hypertension （ P 〈 0.05 ）, and in t

关 键 词：高血压 睡眠呼吸暂停 阻塞性 肥大 左心室 老年人 

分 类 号：R544.1[医药卫生—心血管疾病] R563.5[医药卫生—内科学]