高血压患者左室肥厚与冠脉狭窄程度的关系分析  

Relationship of Left Ventricular Mass Index to Severity of Coronary Artery Stenosis in Patients with Essential Hypertension

作　　者：张桂珍[1] 贺峰[1] 张萱[1] 王晓明[1] 肖竞[1] 

机构地区：[1]北京军区总医院心内科,北京100700

出　　处：《高血压杂志》2003年第2期131-133,共3页Chinese Journal of Hypertension

摘　　要：目的　探讨高血压患者左心室肥厚 (LVH)与冠状动脉狭窄程度之间的相关关系。方法　顺序入选 10 4例住院高血压病患者 ,男 72例 ,女 32例 ,平均年龄 5 9 15± 7 6 8岁。 10 4例病人均进行冠状动脉造影 (CAG)检查 ,并常规进行空腹血糖 (GLU )、三酸甘油酯 (TG)、总胆固醇 (TC)、12导心电图 (ECG)以及超声心动图 (UCG)等检查 ,其中 5 9例病人做了活动平板运动试验 (TEST)。统计学处理采用Spearman等级相关和多元逐步回归法 ,分析LVH的程度与冠状动脉狭窄支数之间的相关关系。结果　Spearman法显示室间隔厚度 (IVST)、左室后壁厚度 (LVPWT)、左室质量指数 (LVMI)与CAG狭窄病变的支数间均有显著等级相关性 (r分别为 0 2 5 ,0 2 1和 0 2 4 ;P均 <0 0 1)。多元逐步回归分析显示 :TEST阳性、GLU、性别 (Sex)、TC、LVPWT以及LVMI与CAG呈显著相关性 (F分别为 7 4 1,8 16 ,7 36 ,6 5 5 ,5 5 5和 6 36 ;P分别为 0 0 0 2 1,0 0 0 2 8,0 0 2 77,0 0 4 0 3,0 0 0 5 7和0 0 0 98)。结论　提示高血压患者除Sex、TC、GLU、TEST结果阳性与冠脉狭窄病变间有显著相关性外 ,IVST、LVPWT以及LVMI与冠脉狭窄病变的支数间有明显的等级正相关 ,即左室壁越厚、LVMI越大者 。Objective To study the relationship of left ventricular mass index (LVMI) to the severity of coronary artery stenosis(CAA)in the patients with essential hypertension (EH). Methods We studied 104 consecutive patients(72 men and 32 women; average age 59.15±7.68 years) with EH Patients underwent coronary angiography (CAG),echocardiography, 12 leads electrocardiograms at rest and modified Bruce protocol exercise test (TEST). Plasma glucose (GLU), triglyceride (TG) and total cholesterol (TC) were measured. The association was examined with Spearman rank order correlation and multiple linear regression analyses. Results Spearman analyses showed that interventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT),and LVMI were significantly correlated to the severity degrees of CAA( r =0 25,0 21 and 0 24 respectively; P <0 01 all) Multivariate regression analyses showed that TEST, GLU, Sex, TC, LVPWT and LVMI, that were strong associated with the severity degrees of CAA (F=7 41, 8 16, 7 36, 6 55, 5 55, and 6 36 respectively; P =0 002, 0 003, 0 028, 0 040, 0 006 and 0 009 respectively). Conclusions Our data suggested that sex, plasma cholesterol and glucose, positive electrocardiographic stress test were significantly associated with the severity of CAA. IVST, LVPWT and LVMI were strongly positive correlated to that of CAA.

关 键 词：原发性高血压 左心室肥厚 左室质量指数 冠状动脉造影 

分 类 号：R541.3[医药卫生—心血管疾病]