老年高血压状态下左心室构型与左心房和左心室容积  

Association of left ventricular geometry with left atrial volume and left ventricular volume in essential hypertensive elderly patients

作　　者：王志峰[1] 马耘[2] 任荣[2] 徐新娟[3] 

机构地区：[1]新疆医科大学第五附属医院老年病/高血压科,新疆维吾尔自治区乌鲁木齐市830011 [2]新疆医科大学第五附属医院肾病科,新疆维吾尔自治区乌鲁木齐市830011 [3]新疆医科大学第一附属医院高血压科,新疆维吾尔自治区乌鲁木齐市830054

出　　处：《中国组织工程研究》2012年第37期6967-6972,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:研究表明,左心房容积可反映左心室充盈压、心房结构重塑及神经激素的活动,左心房容积扩大是预测慢性心力衰竭不良预后的一个强有力的标志。目的:观察老年原发性高血压患者在不同左心室构型情况下左心房容积和左心室容积的变化。方法:采用超声心动图对129例老年原发性高血压患者(高血压组)和125名体检血压正常的老年人(对照组)的左心房容积和左心室容积相关指标进行测量,并依据Ganau标准对左心室几何构型进行分型;同时对老年高血压患者进行动态血压监测,依据血压节律进行分组比较。结果与结论:与对照组比较,高血压组左心房容积、左心房容积指数、左心室收缩末期容积、左心室舒张末期容积均明显增大(P<0.05);同时,在高血压组内,病程和动态血压昼夜节律对左心室几何构型的分布有影响,且左心室构型异常者上述指标较左心室构型正常者增大更明显(P<0.05)。提示,老年原发性高血压患者病程和非杓型血压节律对左心室构型存在重要影响,左心房容积和左心室容积的变化与左心室构型的改变相伴随。BACKGROUND：Studies have shown that left atrial volume may embody left ventricular filling pressure, atrial structural remodeling and neurohormonal activity. Moreover, left atrial volume expansion is a strong predictor of poor prognosis following chronic heart failure. OBJECTIVE：To study the changes of left atrial volume and left ventricular volume in elderly essential hypertension patients based on different left ventricular geometries. METHODS：The left atrial volume and left ventricular volume of 129 essential hypertension elderly patients and 125 control subjects were measured with echocardiography and their differences were analyzed. The left ventricular geometries were classified according to Ganau standard. The essential hypertension group underwent ambulatory blood pressure monitoring in order to grouping comparison based on types of blood pressure rhythm. RESULTS AND CONCLUSION：The left atrial volume, left atrial volume index, end-systolic left ventricular volume, end-diastolic left ventricular volume of the essential hypertension group compared with the control group were increased, and the difference was statistically significant （P 0.05）. In the essential hypertension group, duration of hypertension and rhythm of blood pressure could influence distribution of left ventricular geometries. The left atrial volume, left atrial volume index, end-systolic left ventricular volume, end-diastolic left ventricular volume of the abnormal geometries group compared with the normal geometries group were increased, significantly （P 0.05）. In essential hypertension elderly patients, the disease course and non-dipper blood pressure rhythm have important influence on left ventricular geometry;the left atrial volume and left ventricular volume are changed with different left ventricular geometries.

关 键 词：原发性高血压 老年高血压 心脏构型 左心房容积 左心室容积 左心室重构 老年人 非杓型血压节律 慢性心力衰竭 超声心动图 心血管疾病 

分 类 号：R318[医药卫生—生物医学工程]