不同年龄、性别和高血压级别的中老年高血压患者心肌做功超声心动图指标的差异  

The myocardial work evaluating by echocardiography differed by age,gender and hypertension grade in middle-aged and elderly patients with hypertension

作　　者：罗丽敏 吴艳晴 蒋凌[1,3] 罗顺祥 徐尚华[1,3] LUO Limin;WU Yanqing;JIANG Ling;LUO Shunxiang;XU Shanghua(The School of Clinical Medicine,Fujian Medical University,Fuzhou,Fujian 35000l,China;Department of Echocardiography,Zhongshan Hospital(Xiamen),Fudan University;Nanping First Hospital Affiliated to Fujian Medical University)

机构地区：[1]福建医科大学临床医学部,福建福州350001 [2]复旦大学附属中山医院(厦门)心脏超声诊断室 [3]福建医科大学附属南平市第一医院心内科

出　　处：《中华高血压杂志(中英文)》2025年第1期59-66,共8页Chinese Journal of Hypertension

基　　金：福建省科技创新联合资金项目(2021Y9035)。

摘　　要：目的 研究不同年龄、性别和高血压级别的中老年高血压患者心肌做功超声心动图指标的差异。方法 选取2021年10月至2023年6月就诊于复旦大学附属中山医院(厦门)的40岁以上原发性高血压患者360例,根据年龄分为40~54岁组(n=180)及≥55岁组(n=180),每组再根据性别及血压等级分为6个亚组(各亚组均n=30),比较组间和组内经胸超声心动图评估的心肌做功相关参数。结果 不同性别间比较显示,55岁之前,1级高血压女性患者心肌的整体有用功(GCW)高于男性[(2 623.53±222.46)比(2 418.83±393.89)mmHg%,t=2.478,P=0.017],而在2、3级高血压女性患者中整体纵向应变(GLS)绝对值、整体做功指数(GWI)、GCW及整体无用功(GWW)也高于男性(均P<0.05),同时整体做功效率(GWE)在2级高血压患者中也同样具有性别差异(t=2.698,P=0.009)。55岁之后,1级高血压患者的所有做功参数性别差异无统计学意义(均P>0.05);2、3级高血压患者的GCW和GWI在女性群体中高于男性群体(均P<0.05);2级高血压患者中的GLS绝对值同样也表现为女性高于男性(t=2.176,P<0.05)。同性别间比较显示,女性各级高血压间及男性1级和3级高血压间各做功参数的差异无统计学意义(均P>0.05),男性2级高血压患者GWW在55岁以上人群中大于55岁以下人群,而GWE则相反(均P<0.05)。不同级别高血压对男性的影响主要表现在GLS的差异,对女性影响主要表现在55岁之后GWI的差异(均P<0.05)。结论 在中老年高血压群体中心肌做功表现出性别及年龄差异,且不同级别高血压对不同人群的影响也存在一定的差别。Objective To investigate the differences of echocardiographic parameters of myocardial work in middle-aged and elderly hypertensive patients with different age,gender and hypertension grade.Methods Three hundred and sixty patients with essential hypertension over 40 years old who admitted to Zhongshan Xiamen Hospital of Fudan University from October 2021 to June 2023 were included.According to age,the patients were divided into two groups:40-54 years old group(n=180),and≥55 years old group(n=180).Each group was further divided into 6 subgroups according to gender and hypertension grade(n=30 in each subgroup).The parameters related to myocardial work assessed by transthoracic echocardiography were compared between groups and within groups.Results Before 55 years old,the global constructive work(GCW)of female patients with grade 1 hypertension was higher than that of male patients[(2623.53±222.46)vs(2418.83±393.89)mmHg%,t=2.478,P=0.017],the absolute value of global longitudinal strain(GLS),global work index(GWI),GCW and global wasted work(GWW)of female patients with grade 2 and 3 hypertension were higher than those of male patients(all P<0.05).There was also a gender difference in global work efficiency(GWE)in patients with grade 2 hypertension(t=2.698,P=0.009).After 55 years old,there were no gender differences in all parameters in patients with grade 1 hypertension(all P>0.05).The GCW and GWI of patients with grade 2 and 3 hypertension in female group were higher than those in male group(all P<0.05).The absolute value of GLS in patients with grade 2 hypertension was also higher in women than that in men(t=2.176,P<0.05).Comparison between the same gender showed that there was no significant difference in work parameters between different grades of hypertension in females and between 2 and 3 grades of hypertension in males(all P>0.05).In male patients with grade 2 hypertension,GWW in the population over 55 years old was higher than that in the population under 55 years old,while GWE was opposite(both P<0.05).Th

关 键 词：中老年 高血压 心肌做功 超声心动图 

分 类 号：R54[医药卫生—心血管疾病]