高血压患者动态脉搏波速度与左心室肥厚和左心功能的关系  

Relationship between ambulatory pulse wave velocity and left ventricular structure and function in patients with primary hypertension

作　　者：贾娜[1] 曾学寨[1] 刘德平[1] 张瑞生[1] 王丽娟[2] 徐筑津 周济红 潘春宇[1] 甘宇 乔巍巍[1] JIA Na;ZENG Xue-zhai;LIU De-ping;ZHANG Rui-sheng;WANG Li-juan;XU Zhu-jin;ZHOU Ji-hong;PAN Chun-yu;GAN Yu;QIAO Wei-wei(Department of Cardiology,National Center of Gerontology,Institute of Geriatrics Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Nutrition,National Center of Gerontology,Institute of Geriatrics Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Radiology,Beijing Hospital,National Center of Gerontology,Institute of Geriatrics Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院,国家老年医学中心,中国医学科学院老年医学研究院心内科,北京市100730 [2]北京医院,国家老年医学中心,中国医学科学院老年医学研究院营养科,北京市100730 [3]北京医院,国家老年医学中心,中国医学科学院老年医学研究院放射科,北京市100730

出　　处：《中国心血管病研究》2020年第5期395-400,共6页Chinese Journal of Cardiovascular Research

基　　金：国家自然科学基金(51672030)。

摘　　要：目的探讨高血压患者动态脉搏波速度(pulse wave velocity,PWV)与左心室重构和左心室舒张功能的关系.方法本研究回顾性收集2011年5月至2013年1月于卫生部北京医院门诊或住院的≥18岁的原发性高血压患者,采用Mobil-O-Graph PWA无创动态血压监测仪测量动态血压和动态PWV.同期进行超声心动图检查,评估左心室结构和功能.采用Pearson相关分析,比较动态PWV和左心室结构功能参数之间的相关性.采用二元Logistics回归分析,分析动态PWV、年龄、性别、体重指数、糖尿病、吸烟、血脂异常和是否服用降压药物对左心室肥厚(LVH)的影响.结果总共有136患者纳入此研究.平均年龄(55.4±14.1)岁,72.1%为男性.动态PWV平均值为(8.10±1.97)m/s,动态PWV与左心室质量指数(LVMI)(r=0.257,P=0.003)和左心房前后径(r=0.431,P<0.001)呈显著正相关,与E/A比值呈显著负相关(r=-0.337,P<0.001).二元logistic回归分析显示,高血压患者动态PWV是LVH的独立危险因素.结论高血压患者中,动态PWV与LVMI相关,可能是LVH的独立危险因素.Objective To investigate the correlation between ambulatory pulse wave velocity(PWV)and left ventricular structure and function in primary hypertensive patients.Methods Primary hypertension patients whose age≥18 years old in Beying Hospital from May of 2011 to January of 2013 were enrolled.Ambulatory blood pressure monitoring and ambulatory PWV were accessed by Mobil-O-Graph PWA hemomanometer.Left ventricular structure and function were assessed by transthoracic echocardiography.Pearson correlation analysis was used to evaluate the relationship between ambulatory PWV and left ventricular structure and function.Bilateral Logistic regression analysis was used to analyze the influence of ambulatory PWV,age,sex,body mass index,diabetes,smoking,dyslipidemia and anti-hypertensive drug for left ventricular hypertrophy(LVH).Results A total of 136 primary hypertensive patients were finally enrolled.Ambulatory PWV average value was(8.10±1.97)m/s.Ambulatory PWV was significantly positive correlated with left ventricular mass index(LVMI)(r=0.257,P=0.003)and left atrial diameter(r=0.431,P<0.001),but negative correlated with E/A ratio(r=-0.337,P<0.001).Bilateral Logistic regression analysis showed that ambulatory PWV was an independently risk factor for LVH in the hypertensive patients.Conclusion Ambulatory PWV is correlated with LVMI and it may be an independent risk factor for LVH in hypertensive patients.

关 键 词：高血压 脉搏波速度 动态血压 左心室肥厚 

分 类 号：R544.1[医药卫生—心血管疾病]