左心室构型对原发性高血压患者左心功能和房颤影响的分析  

Effect of left ventricular geometric model to left heart function and atrial fibrillation in patients with essential hypertension

作　　者：林建珍[1,2] 林金秀[3] 白萍[1,2] 张志民[1,2] 章文杰[1,2] 

机构地区：[1]福建卫生职业技术学院附属医院 [2]福建省级机关医院内科,福州350001 [3]福建医科大学附属第一医院心内科

出　　处：《福建医药杂志》2015年第2期5-7,23,共4页Fujian Medical Journal

基　　金：福建省卫生厅青年科研课题(2009-2-35)

摘　　要：目的探讨不同左心室构型对原发性高血压患者左心功能及心房颤动的影响。方法将我科收集的3 671例原发性高血压患者按左心室构型分为4组,分别为左心室几何构型正常组(NG组)1 468例,左心室向心性重构组(CR组)324例,左心室向心性肥厚组(CH组)792例和左心室离心性肥厚组(EH组)1 078例,比较4组的左心功能和房颤发生率。将患者是否有房颤分为房颤组593例和非房颤组3 078例,比较两组的左心功能和结构指标。结果 4组不同构型比较,EH组左心功能指标EF值最低(P<0.05)、E/A值最高(P<0.05)。与NG组比较,CR组、CH组和EH组的房颤发生率明显增加(P<0.05)。与非房颤组比较,房颤组的LAD、LVEDD、EF值、E/A值、LVMI差异有统计学意义(P<0.05)。根据多因素Logistic回归分析,E/A值、左心室舒张末期内径(LVEDD)是房颤发生的独立危险因子。结论随着原发性高血压患者左心室几何构型的逐渐进展,房颤发生率逐渐提高,患者左心功能逐渐下降,E/A值是房颤发生的重要预测因素,左心室构型中的LVEDD和房颤的关系紧密。Objective To investigate the effect of left ventricular geometric model to left heart function and atrial fibrillation（AF）in patients with essential hypertension.Methods According to Ganau categories,these patients were divided into four groups：normal LV geometric model（NG group）,concentric remodeling（CR group）,concentric hypertrophy（CH group）and eccentric hypertrophy（EH group）.We compared the four groups of left heart function and incidence of AF and compared the left heart function and structure index between AF patientsgroup and NAF（without AF）one.Results Compared with other 3groups,The heart function in EH group was worst（EF was the minimum,E/A was the highest）.Compared with NG group,the incidence of AF in other three groups were all higher（P〈0.05）.There was significant difference between AF group and NAF group in the LAD、LVEDD、EF、LVMI numerical and E/A ratio.4According to Logistic regression Multiple-factors analysis,the E/A ratio and Left ventricular end diastolic diameter（LVEDD）were independent risk factors of AF.Conclusion The incidence of AF in patients with essential hypertension is increased following the developing of LV geometric model,but the heart function becomes worse with it,E/A ratio is the important predictor for AF,LVEDD is the strongest correlation sign between AF and LV geometric model.

关 键 词：高血压 左心室构型 左心功能 心房颤动 

分 类 号：R544.1[医药卫生—心血管疾病]