老年人脉压及组分与左心室结构及舒张功能的相关性研究  

Relationship of different pulse pressures with left ventricular structure and diastolic function in the elderly

作　　者：姜宇琦 张桓睿 杨煜[1] 刘勃楠 孙宇姣[1] 田文[1] Jiang Yuqi;Zhang Huanrui;Yang Yu;Liu Bonan;Sun Yujiao;Tian Wen(Department of Geriatrics,First Affiliated Hospital of China Medical University,Shenyang 110001,Liaoning Province,China)

机构地区：[1]中国医科大学附属第一医院老年医学科,沈阳110001

出　　处：《中华老年心脑血管病杂志》2022年第4期371-375,共5页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：“十三五”国家重点研发计划项目(2018YFC2000301)。

摘　　要：目的探讨诊室脉压、24 h平均脉压、弹性脉压(elPP)和硬化脉压(stPP)作为动脉硬化参数的可靠性及其与左心室结构和舒张功能的相关性。方法回顾分析2020年6月~2021年8月于我院老年医学科住院的老年患者111例,根据患者有无左心室结构或舒张功能异常分为异常组62例和正常组49例,分析比较脉压及其组分与肱踝脉搏波传导速度(baPWV)以及左心室结构和舒张功能的相关性。结果异常组诊室脉压、24 h平均脉压、elPP和stPP明显高于正常组(P<0.01)。诊室脉压、24 h平均脉压、elPP和stPP均与左心室结构或舒张功能异常显著相关(95%CI:1.369~3.550,P=0.001;95%CI:1.453~3.307,P=0.000;95%CI:1.351~3.754,P=0.002;95%CI:1.211~4.435,P=0.011)。诊室脉压、24 h平均脉压、elPP和stPP诊断左心室结构或舒张功能异常的曲线下面积分别为0.668、0.713、0.664、0.658(P<0.01)。结论在射血分数正常的老年人中,脉压及其组分不仅指示动脉硬化程度,还可以作为左心室结构或舒张功能异常早期筛查的可靠指标。Objective To study the relationship of office pulse pressure(PP),24 h mean PP,elastic PP and stiffening PP with left ventricular structure and diastolic function in the elderly.MethodsOne hundred and eleven elderly patients admitted to our hospital from June 2020 to August 2021 were divided into abnormal left ventricular structure or diastolic function group(n=62) and normal left ventricular structure or diastolic function group(n=49).The relationship of office PP,24 h mean PP,elastic PP and stiffening PP with baPWV,left ventricular structure and diastolic function in the elderly was analyzed.Results The office PP,24 h mean PP,elastic PP and stiffening PP were significantly higher in abnormal left ventricular structure or diastolic function group than in normal left ventricular structure or diastolic function group(P<0.01).Office PP,24 h mean PP,elastic PP and stiffening PP were positively related with left ventricular structure or diastolic function in the elderly(95%CI:1.369-3.550,P=0.001;95%CI:1.453-3.307,P=0.000;95%CI:1.351-3.754,P=0.002;95%CI:1.211-4.435,P=0.011).The AUC of office PP,24 h mean PP,elastic PP and stiffening PP was 0.668,0.713,0.664 and 0.658 respectively(P<0.01).Conclusion Office PP,24 h mean PP,elastic PP and stiffening PP can be used as biomarkers of arteriosclerosis and reliable indicators of abnormal left ventricular structure or diastolic function in the elderly with normal ejection fraction.

关 键 词：动脉压 动脉硬化 心室功能 左 心室重构 每搏输出量 

分 类 号：R543.5[医药卫生—心血管疾病]