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高血压病患者左心室功能的改变

THE LEFT HEART FUNCTION IN HYPERTENSION

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【作者】 周宏研; 孙明; 钟幼琼; 王文军; 肖克谷; 王振华;

【Author】 Zhou Hongyan Sun Ming Chung Youqiong Wang Wenjun Hiao Kegu Wang ZhenhuaDepartment of Medicine, The First Affiliated Hospital, Hunan Medical College

【机构】 湖南医学院第一附属医院内科; 湖南医学院第一附属医院内科;

【摘要】 用STI及ACG对60例正常人和81例高血压病患者左心室收缩和舒张功能的研究。高血压病各组患者左心室收缩和舒张功能指标的均值及异常检出率,明显高于对照组(p<0.01)。1/6高血压病患者心电图出现左心室肥大,半数左右高血压病患者出现PEPI、P/L、A/D的均值异常,约3倍于左心室肥大。说明STI及ACG较心电图能更早地发现高血压病患者左心室功能改变。

【Abstract】 The left heart function of 81 hypertensive patients were measured by STI and ACG in comparison with 60 normal controls. The patients were divided into Group 1, without cardiac hypertrophy and Group 2, with cardiac hypertrophy. There was a significant difference in systolic function (prolonged PEPI, shortened LVETI, and increased P/L ratio) in hypertensive patients as compared to controls. The diastolic pressure was related with PEPI in hypertensive patients. (r = 0.3428 P<0.01). PEPI was significantly prolonged in group 2 than in group 1. P/L was related with the diastolic pressure (r= 0.3060, P<0.01), and P/L ratio increased more in group 2 than in group l. There was a significant difference in diastolic function (prolonged A2OI, both A/H and A/D ratio increased) in hypertensive patients as compared to controls. In control group both the A/H and A/D ratiodid not increase whereas in hypertensive group the A/H and A/D increased by 32.1% and 42.0% respectively. According to this study the A/D ratio was better than the A/H ratio in estimation of the compliance of left ventricle in hypertension. There was a significant difference between hypertensive and control groups (p<0.01), but it was not significant between group l and group 2. P/L (systolic function), A2OI and A/D (diastolic function) were selected to evaluate the left ventricular function in hypertension. Systolic function alone was abnormal in 51.3% patients and diastolic function alone was abnormal in 48.2% patients. The hypertrophic left ventricle was revealed in 16% of the patients by ECG and 37% of the patients by X-Ray. Therefore STI and ACG may be more sensitive in detecting abnormal heart function in hypertension.

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