体质指数与初诊高血压患者早期心功能变化的关系  

Relationship between body mass index and early changes of heart function in patients with initially diagnosed hypertension

作　　者：刘欢[1] 杨锦龙[2] 张晋[1] 许丹[1] 刘洪波[2] Liu Huan;Yang Jinlong;Zhang Jin;Xu Dan;Liu Hongbo(Department of Endocrinology and Metabolism,People's Hospital of Leshan City,Leshan 614000,China.;不详)

机构地区：[1]乐山市人民医院内分泌代谢科,乐山614000 [2]乐山市人民医院心血管内科,乐山614000

出　　处：《中国循证心血管医学杂志》2023年第2期213-217,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨出诊的高血压患者的体质指数(BMI)与左室舒张功能障碍与左室重构之间的关系。方法本研究纳入2021年1月至2021年12月于乐山市人民医院心内科及内分泌科门诊就诊,初次诊断为高血压的患者127例。根据BMI中位数分为两组,BMI≤26.7 kg/m^(2)为较低BMI组(n=57),BMI>26.7 kg/m^(2)为较高BMI组(n=70)。采用二维和多普勒超声心动图检查来评估两组患者左室舒张功能和结构的差异。结果在较高BMI组的患者中,左心房容积指数(LAVI,P<0.001)增加,左室质量指数(LVMI,P=0.014)增加,E/e'比值(P<0.001)升高,e'速度(P<0.001)减慢和E/A比值(P=0.023)下降。相关性分析提示体质指数与这些参数之间有统计学意义的相关性(P<0.05)。逐步多元回归分析显示,BMI与左室舒张功能和结构的关系与潜在的混杂因素无关(P<0.001)。结论较高BMI可能反映了初诊高血压患者的亚临床左室舒张功能和结构的损害。当确诊高血压伴有较高BMI或肥胖倾向时,建议进行详细超声心动图检查,以便定制更加优化的干预策略。Objective To investigate the relationship among body mass index(BMI),left ventricular diastolic dysfunction(LVDD)and left ventricular remodeling in patients with initially diagnosed hypertension.Methods The patients with initially diagnosed hypertension(n=127)were chosen from People’s Hospital of Leshan City from Jan.2021 to Dec.2021.All patients were divided,according to BMI median,into low-BMI group(BMI≤26.7 kg/m^(2),n=57)and high-BMI group(BMI>26.7 kg/m^(2),n=70).The difference in left ventricular diastolic function and structure was reviewed by using two-dimensional echocardiogram and color Doppler echocardiogram between 2 groups.Results In high-BMI group,the indexes of left atrial volume index(LAVI,P<0.001)and left atrial mass index(LVMI,P=0.014)increased,and E/e'ratio(P<0.001),e'velocity(P<0.001)and E/A ratio(P=0.023)decreased.The results of correlation analysis showed that the correlation among BMI and above indexes had statistical significance(P<0.05).The results of stepwise multiple regression analysis showed that the relationship among BMI and left ventricular diastolic function and structure was not correlated to potential confounding factors(P<0.001).Conclusion Higher BMI may reflect the impairments of subclinical left ventricular diastolic function and structure in patients with initially diagnosed hypertension.When diagnosed hypertension accompanied by higher BMI or adiposity tendency,detailed echocardiography can be recommended in order to develop more optimized intervention strategies.

关 键 词：体质指数 高血压 左心室舒张功能 左心室重构 

分 类 号：R544.1[医药卫生—心血管疾病]