高尿酸血症对中青年高血压患者左室重构和收缩功能的影响  

Impact of hyperuricemia on left ventricular remodeling and systolic function in young and middle-aged patients with hypertension

作　　者：张盼盼 相三婷 童梦佳 张玲玲 ZHANG Pan-pan;XIANG San-ting;TONG Meng-jia;ZHANG Ling-ling(Department of Ultrasonic Diagnosis,Jiangning Hospital Affiliated to Nanjing Medical University(Jiangning Clinical Medical College of Kangda College of Nanjing Medical University),Nanjing 210000,Jiangsu,CHINA)

机构地区：[1]南京医科大学附属江宁医院(南京医科大学康达学院附属江宁临床医学院)超声诊断科,江苏南京210000

出　　处：《海南医学》2025年第6期837-841,共5页Hainan Medical Journal

基　　金：南京医科大学康达学院2022度科研发展基金课题(编号:KD2022KYJJD063)。

摘　　要：目的探讨高尿酸血症对中青年高血压患者左室重构和收缩功能的影响,并分析左室应变(Gls)参数判断左室重构的诊断价值。方法回顾性选取2022年1月至2023年12月在南京医科大学附属江宁医院入院治疗的112例中青年高血压患者作为研究对象,根据血尿酸水平分为单纯高血压组72例(SUA≤420μmol/L)和高血压合并高尿酸血症组40例(SUA>420μmol/L),选取同时段健康体检者66例作为对照组。三组受检者均接受超声心动图检查获取常规参数[左室舒张末期内径(LVDD),左室收缩末期内径(LVDS),室间隔舒张末期厚度(IVS),左室后壁舒张末期厚度(LVPW),左室射血分数(LVEF),左室短轴缩短率(FS),左室质量指数(LVMI),相对室壁厚度(RWT)]及左室应变参数[心尖四腔心左室峰值纵向应变(Gls-A4C)、心尖三腔心左室峰值纵向应变(Gls-A3C)、心尖两腔心左室峰值纵向应变(Gls-A2C),平均左室峰值纵向应变(Gls-AVG)],比较三组间各参数的差异以及各组左室形态构成比的差异;采用受试者工作特征(ROC)曲线分析左室应变参数对左室重构的诊断价值。结果单纯高血压组、高血压合并高尿酸血症组与对照组受检者的常规参数IVS[(11.13±1.22)mm vs(11.38±1.43)mm vs(9.47±0.79)mm]、LVPW[(10.57±1.09)mm vs(10.98±1.29)mm vs(9.64±0.79)mm]、LMVI[(98.76±20.97)g/m^(2) vs(96.12±23.43)g/m^(2) vs(84.37±0.79)g/m^(2)]及RWT[(0.46±0.06)vs(0.48±0.08)vs(0.41±0.03)]比较,单纯高血压组、高血压合并高尿酸血症组均大于对照组,差异均有统计学意义(P<0.05),但单纯高血压组患者的IVS、LVPW、LMVI、RWT与高血压合并高尿酸血症组比较差异均无统计学意义(P>0.05)。单纯高血压组、高血压合并高尿酸血症组与对照组受检者的左室应变参数Gls-AVG[(-17.60±3.12)%vs(-15.73±2.92)%vs(-23.39±2.30)%]、Gls-A4C[(-17.57±2.97)%vs(-16.14±3.16)%vs(-22.61±2.26)%]、Gls-A3C[(-18.38±3.45)%vs(-15.17±3.32)%vs(-22.38±2.45)%]、Gls-A2C[(-19.42�Objective To investigate the impact of hyperuricemia on left ventricular(LV)remodeling and systolic function in young and middle-aged hypertensive patients and to evaluate the diagnostic value of LV global longitudinal strain(Gls)parameters in assessing LV remodeling.Methods A retrospective study was conducted on 112 young and middle-aged hypertensive patients admitted to Jiangning Hospital Affiliated to Nanjing Medical University from January 2022 to December 2023.Patients were divided into two groups based on serum uric acid(SUA)levels:hypertension-only group(n=72,SUA≤420μmol/L)and hypertension with hyperuricemia group(n=40,SUA>420μmol/L).Sixty-six healthy individuals were included as controls.All participants underwent echocardiography to obtain conventional parameters(LV end-diastolic diameter[LVDD],LV end-systolic diameter[LVDS],interventricular septal thickness at end-diastole[IVS],LV posterior wall thickness at end-diastole[LVPW],LV ejection fraction[LVEF],fractional shortening[FS],LV mass index[LVMI],relative wall thickness[RWT])and LV strain parameters(peak longitudinal strain in apical four-chamber view[Gls-A4C],apical three-chamber view[Gls-A3C],apical two-chamber view[Gls-A2C],and average peak longitudinal strain[Gls-AVG]).Differences in parameters and LV morphology among groups were compared.Receiver operating characteristic(ROC)curves were used to evaluate the diagnostic value of LV strain parameters for LV remodeling.Results IVS,LVPW,LVMI,and RWT were significantly higher in the hypertension-only and hypertension with hyperuricemia groups compared to controls(all P<0.05),but no significant differences were observed between the two hypertensive groups(P>0.05):IVS,(11.13±1.22)mm vs(11.38±1.43)mm vs(9.47±0.79)mm;LVPW,(10.57±1.09)mm vs(10.98±1.29)mm vs(9.64±0.79)mm;LMVI,(98.76±20.97)g/m^(2) vs(96.12±23.43)g/m^(2) vs(84.37±0.79)g/m^(2);RWT,(0.46±0.06)vs(0.48±0.08)vs(0.41±0.03).Gls-AVG,Gls-A4C,Gls-A3C,and Gls-A2C were significantly lower in both hypertensive groups compared to controls,wi

关 键 词：斑点追踪成像 中青年 高血压 高尿酸血症 左室重构 左室纵向峰值应变 诊断价值 

分 类 号：R544.1[医药卫生—心血管疾病]