高血压患者动态动脉硬化指数与射血分数保留性心力衰竭严重程度的关系研究  

Relationship between dynamic arteriosclerosis index and severity of heart failure with preserved ejection fraction in hypertensive patients

作　　者：吴淑甜 张鑫娜 韩俊娜 WU Shu-tian;ZHANG Xin-na;HAN Jun-na(Department of Emergency,The Third Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China;Department of Emergency,Zhengzhou People's Hospital,Zhengzhou 450000,China;Emergency Ward,The Third Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第三附属医院急诊科,郑州450000 [2]郑州人民医院急诊科,郑州450000 [3]河南中医药大学第三附属医院急诊病区,郑州450000

出　　处：《医药论坛杂志》2023年第7期41-45,共5页Journal of Medical Forum

摘　　要：目的 探讨动态动脉硬化指数(AASI)在高血压伴射血分数保留性心力衰竭(HFpEF)患者中的变化,同时研究AASI与心室重构相关指标、心功能之间的相关性。方法 选择2020年9月—2022年3月河南中医药大学第三附属医院收治的144例高血压患者为研究对象,按照是否合并HFpEF分成A组(合并HFpEF,n=70)和B组(未合并HFpEF,n=74),且A组根据纽约心脏病学会心功能分级分成Ⅰ组(Ⅱ级)38例和Ⅱ组(Ⅲ~Ⅳ级)32例。对患者基本资料进行记录,患者入院后空腹采血送实验室检验,同时开展心脏超声心动图检查,对其各项心脏彩超指标进行记录,采用Pearson相关性探讨AASI与心室结构相关指标及心功能之间的关系。结果 两组性别、年龄、体重指数(BMI)、心率(HR)、血压、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、空腹血糖、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、总胆固醇(CHO),钙通道总阻滞剂(CCB)、β-受体拮抗剂及ARB/ACEI服用比例比较差异无统计学意义(P>0.05);两组BUN、Scr、利尿剂服用比例比较差异有统计学意义(P<0.05);A组LVEF、LVMI、LVDd、NT-proBNP及AASI水平分别为(57.76±4.45)%、(125.47±22.99)g/m^(2)、(53.38±6.17)mm、(1805.83±588.86)ng/L及(0.57±0.11),与B组各项检测指标比较,差异有统计学意义(P<0.05);Ⅱ组LVEF(54.77±4.52)%低于Ⅰ组的(59.97±4.78)%,LVMI、LVDd、NT-proBNP和AASI指标则均高于Ⅰ组,差异有统计学意义(P<0.05);A组AASI与NT-proBNP(r=0.397,P<0.05)、LVDd(r=0.418,P<0.05)及LVMI(r=0.421,P<0.05)呈正相关,与LVEF(r=-0.317,P<0.05)呈负相关。结论 高血压合并HFpEF患者AASI较高,和心室重构程度、心功能变化存在一定关系,且与HFpEF的发生可能有关。Objective To investigate the changes of dynamic arteriosclerosis index(AASI) in patients with hypertension and heart failure with preserved ejection fraction(HFpEF),and to investigate the correlation between AASI and ventricular remodeling indexes and cardiac function.Methods A total of 144 hypertensive patients admitted to the Third Affiliated Hospital of Henan University of Chinese Medicine from September 2020 to March 2022 were selected as the research objects and divided into group A(combined with HFpEF,n=70) and group B(without HFpEF,n=74).Group A was divided into group Ⅰ(grade Ⅱ)(n = 38) and group Ⅱ(grade Ⅲ-Ⅳ)(n=32) according to the New York Cardiology Association classification.The basic data of the patients were recorded.After admission,fasting blood was collected and sent to the laboratory for test.At the same time,cardiac echocardiography was performed to record the various cardiac color ultrasound indexes.Results There were no significant differences in gender,age,BMI,HR,blood pressure,AST,ALT,fasting blood glucose,TG,LDL,HDL,CHO,CCB,β-receptor antagonist and ARB/ACEI between the two groups(P>0.05).There were statistically significant differences in BUN,Scr and diuretic consumption ratio between the two groups(P<0.05).The levels of LVEF,LVMI,LVDd,NT-probNP and AASI in group A were(57.76±4.45) %,(125.47±22.99) g/m^(2),(53.38±6.17) mm,(1805.83±588.86) ng/L and(0.57±0.11),respectively.The detection indexes of group B were(61.97±4.44) %,(110.42±18.09) g/m~2,(47.29±6.39) mm,(78.44±27.39) ng/L and(0.49±0.17),and the difference was statistically significant(P<0.05).LVEF of group Ⅱ(54.77±4.52) % was lower than that of group Ⅰ(59.97±4.78) %,LVMI,LVDd,NT-probNP and AASI of group Ⅱ were higher than those of group Ⅰ(P<0.05).In group A,AASI was positively correlated with NT-probNP(r=0.397,P<0.05),LVDd(r=0.418,P<0.05) and LVMI(r=0.421,P<0.05),and negatively correlated with LVEF(r=-0.317,P<0.05).Conclusion AASI is higher in hypertensive patients with HFpEF,which is related to the degree

关 键 词：动态动脉硬化指数心室重构 射血分数保留性心力衰竭 高血压 

分 类 号：R544.1[医药卫生—心血管疾病]