中青年难治性高血压患者心室-动脉耦联的初步探讨  

Preliminary study on ventricular-arterial coupling in young patients of resistant hypertension

作　　者：杜天天[1,2] 庞敏[3] 蔡情情 杨波 厉志洪 李春梅[1,5] 王雷[1,5] 宫海滨[1,5] 

机构地区：[1]徐州市心血管病研究所,江苏徐州221009 [2]徐州市中心医院急诊科,江苏徐州221009 [3]徐州市中心医院超声科,江苏徐州221009 [4]徐州医科大学研究生学院,江苏徐州221009 [5]徐州市中心医院心内科,江苏徐州221009

出　　处：《现代医学》2017年第5期634-637,共4页Modern Medical Journal

基　　金：江苏省临床医学科技专项基金资助项目(BL2012019);徐州市社会发展基金资助项目(XM12B062)

摘　　要：目的:初步探讨中青年难治性高血压(RH)患者的心脏、血管弹性的变化。方法:选择中青年(18~65岁)RH患者、可控性高血压(CH)患者和血压正常(NT)者各50例,分别检测中心动脉压、颈股脉搏波传导速度(cf PWV)、增强指数(AIx@75%)、左室结构、左室舒张功能(E/e)和血流动力学等参数,计算心室-动脉耦联等指标。结果:cfPWV值RH组高于CH组及NT组(均P<0.05),CH组高于NT组(P<0.05)。有效动脉弹回(Ea)、左室收缩末弹回(Ees)、左室舒张末弹回(Eed)值RH组高于CH及NT组(均P<0.05)。多因素线性回归分析显示,在总体人群中AIx@75%是心室-动脉耦联指数的独立危险因素。结论:中青年RH患者的心室及动脉僵硬增加,心室-动脉匹配关系发生了变化。Objective： To evaluate the change of heart and vascular elasticity in young and middle-aged patients with resistant hypertension（RH）. Methods： Fifty young and middle-aged patients （18-65 years old） with RH, 50 patients with controlled hypertension （CH） and 50 patients with normotensives （NT） were enrolled in this study. All subjects were performed examinations including center arterial pressure, carotid femoral artery pulse wave velocity （ cfPWV）, augmentation index （ AIx@ 75% ）, structure and diastolic function （ E/e ） of left ventricular and hemodynamic parameters. Then the heart and artery elasticity as well as corresponding parameters were calculated.Results： cfPWV in RH group increased faster than CH group and NT group （ all P 〈 0.05 ） and CH patients was also faster than NT group （ P 〈 0.05 ）. Effective arterial elastance （ Ea）, end systolic ventricular elastance （ Ees）, end diastolic ventricular elastance（Eed） of RH group were higher than those of CH group and NT group （ all P 〈 0. 05 ）. Multi-factor linear regression analysis showed that AIx@ 75% was the independent risk factor for ventricular- arterial coupling index（VACI） in the general population. Conclusions： The ventricle and arterial stiffness in young and middle-aged patients with RH are more severe, and their matching relationship also changes.

关 键 词：难治性高血压 中青年 心室功能 动脉僵硬度 心室-动脉耦联 

分 类 号：R544.1[医药卫生—心血管疾病]