108例85岁以上高血压老年人超声心动图分析  

Cardiac structure and function assessed by echocardiography in hypertensive patients aged 85 and over

作　　者：王岚[1] 丁林锋[1] 赵坚[1] 李静[1] 王屹[1] 

机构地区：[1]江苏省省级机关医院心内科,江苏省南京市210024

出　　处：《实用老年医学》2014年第8期649-651,654,共4页Practical Geriatrics

摘　　要：目的通过对>85岁伴有高血压的老年人进行超声心动图检查,分析高血压老年人的心脏结构特征。方法对2012年12月至2013年6月就诊的108例>85岁合并高血压的老年人进行超声心动图检查,测量主动脉瓣口面积(AVA),主动脉、左心房、室间隔、左心室后壁直径(LPWd)及左心室舒张末期内径(LVDd);计算左心室射血分数(LVEF)、心排量(CO)和心指数(CI)。结果本组研究对象中糖尿病、冠心病和腔隙性脑梗死为最常见伴发疾病,分别为33例(30.6%),31例(28.7%)和23例(21.3%)。超声心动图显示:主动脉直径(AOD)(3.0±0.3)cm,左心房内径(LAD)(3.5±0.5)cm,室间隔厚度(IVS)(0.9±0.1)cm,LPWd(0.9±0.1)cm,LVDd(4.5±0.4)cm,AVA(1.8±0.2)cm2,LVEF(64.8±3.9)%,CO(4.2±1.0)L/min,CI(2.6±0.5)L/(min·m2)。左心室舒张功能减退107例(99.0%),收缩功能减退2例(1.8%),左心房扩大者25例(23.1%),轻度主动脉瓣狭窄(伴或不伴钙化)7例(6.5%),中度主动脉瓣关闭不全9例(8.3%),重度主动脉瓣关闭不全1例(0.9%),中度二尖瓣关闭不全7例(6.5%),中度三尖瓣关闭不全6例(5.6%),重度三尖瓣关闭不全1例(0.9%)。结论 >85岁高血压老年人心脏结构改变以左心房扩大最为常见,心室无明显肥厚表现,CO处于正常低值。Objective To analyze the characteristics of cardiac structure and function by echocardiography in patients with hypertension aged 85 and over. Methods 108 hypertensive patients aged 85 and over were enrolled. Aortic valve area, the diameters of aortic root, left atrium, left ventricle, ventricular septum and cardiac output were measured by two dimension echocardiography. Results Diabetes, coronary artery disease and lacunar infarction were the most common concomitant diseases with 33 cases （30. 6%）, 31 cases （28.7%） and 23 cases （21.3%）, respectively. The mean values of AOD, LAD, IVS, LPWd, LVDd, AVA, LVEF, CO and CI were （3.0±0. 3） cm, （3.5±0. 5） cm, （0. 9 ±0. 1）cm,（0.9±0. 1） cm, （4.5±0.4） cm, （1.8±0.2） cm2, （64.8±3.9）%, （4.2±1.0） L/min, （2.6±0.5）L/（min · m2 ）, repectively. 107 cases （ 99. 0% ） showed left ventricular diastolic dysfunction, 2 cases （ 1.8% ） showed left ventricular systolic dysfunction. Left artial dilation occurred in 25 cases （23. 1% ）. Mild, moderate and severe aortic regurgitation were found in 7 cases （6. 5%） ,9 cases （8. 3%） ,and 1 case （0. 9%）, respectively. Moderate mitral and tricuspid regurgitation were found in 7 cases （6. 5%） and 6 cases （5.6%）. Only 1 case （0.9%） showed severe tricuspid regurgitation. Conclusions In hypertensive patients aged 85 years and over, dilated left atrium is the most common echo manifestation accompanied with absence of left ventricular hypertrophy. The level of CO reaches the lower limit of normal.

关 键 词：85岁以上 老年人 高血压 超声心动图 

分 类 号：R544.1[医药卫生—心血管疾病] R445.1[医药卫生—内科学]