老年高血压病左室肥厚与神经体液因素及室性早搏的相关性  

The Relation between Hypertensive Left Ventricular Hypertrophy in the Elderly with Neurohormonal Factors and Ventricular Arrhythmias

作　　者：郭航远[1] 鲁端[1] 王建安[1] 何红[1] 张湘兰[1] 周斌全[1] 蒋晨阳[1] 

机构地区：[1]浙江大学医学院附属邵逸夫医院,浙江杭州310016

出　　处：《科技通报》2001年第1期63-66,共4页Bulletin of Science and Technology

摘　　要：为探讨老年高血压病左室肥厚 ( L VH)与部分神经体液因素之间的关系及与室性早搏、心肌缺血的相关性 .老年高血压病伴左室肥厚 60例为 A组 ;单纯老年高血压病 60例为 B组 .对比观察心率变异、肾素 ( Ren)、血管紧张素 ( AT- )、醛固酮 ( Ald)、胰岛素峰值 ( Ins)、2 4 h动态心电图和血压等指标 .结果显示 :1) A组病人交感神经张力明显增高 ,迷走神经活性下降不明显 ;室性早搏的发生与交感神经张力增高有关 ;室性早搏与心肌缺血具有相关性 ;2 ) A组病人与 Ald及 Ins水平有关 ,与 Ren和 AT- 无明显相关 ;3) A组病人与室性早搏和心肌缺血明显相关 .结论表明 :老年高血压病左室肥厚患者交感神经张力增高 ,Ald及 Ins水平升高 ,与室性早搏、心肌缺血具有正相关 .In order to study the relation between hypertensive left ventricular hypertrophy (LVH)in the elderly with neurohormone factors and ventricular arrhythmias,measurements were made on the heart rate variation,rein(Ren),angiotensin Ⅱ(AT Ⅱ),aldosterone(Ald),insulin(Ins),Holter and Ambulatory blood pressure which were monitored in 120 cases of 2 groups:60 with primary hypertension in the elderly and LVH(group A);60 with simple primary hypertension in the elderly (group B).There was no significant difference between group AT Ⅱ and Ren group A and group B ( P >0.05);Ins and Ald value in group A was much higher than group B(Pall<0.01).Very lower frequency (VLF),low frequency(LF)and LF/HF(high frequency)in group A were significantly higher than group B( P <0.01,0.05,0.05,respectively).Incidence of premature ventricular beats and myocardial ischemia in group A were higher than those in group B.From the above study we had the following findings in group A:(1)Sympathetic nerve excitability was greatly increased;(2)Hypertensive LVH were closely associated with Ald and Ins level,but not with AT Ⅱ and Ren;(3)There was obvious connection between premature ventricular beats and ischemia.

关 键 词：高血压 老年 左室肥厚 神经体液 室性早搏 心肌缺血 交感神经张力 迷走神经活性 相关性 

分 类 号：R544.1[医药卫生—心血管疾病]