【摘要】 目的　探讨高血压病患者左心室几何构型对左心房结构及功能的影响。方法　对 13 8例高血压病患者和 86例正常者的超声心动图参数进行检测。依据左室质量指数 (LVMI)、相对室壁厚度 (RWT)将 13 8例高血压病患者分为左室正常构型组 (5 8例 )、向心性重构组 (2 2例 )、向心性肥厚组 (2 1例 )、离心性肥厚组 (3 7例 )。应用单元和多元回归分析观察左房内径指数 (LADI)、左房射血力 (LAEF)与各项指标的关系。结果　高血压病各组的LADI、LAEF与对照组比较 ,差异有显著性意义 (P <0 .0 5 )。单因素相关分析显示高血压病组LADI与年龄、病程、体质量指数、收缩压、LVMI、舒张末期室间隔厚度 (IVS)、等容舒张时间 (IVRT)、E波减速时间 (EDT)、E波与A波峰速比值 (E/A)相关 (P <0 .0 5 ) ;LAEF与年龄、收缩压、LVMI、IVS、IVRT、EDT、E/A相关 (P <0 .0 5 )。逐步回归分析显示LADI与LVMI、年龄、收缩压、IVRT、EDT独立相关 (r =0 .481,r2 =0 .2 3 1) ;LAEF与LVMI、IVRT、E/A独立相关 (r =0 .3 76,r2 =0 .14 1)。结论　LADI、LAEF增大出现于高血压病患者左室肥厚之前 ,并存在于各种左室几何构型中。肥厚性左室构型、年龄、收缩压及舒张功能指标分别与左房扩大及做功增强独立相关 ,是导致高血压病患者左房结构和功能变?更多还原

【Abstract】 Objective To investigate the effects of the left ventricular geometry on left atrial structure and function in essential hypertension (EH).Methods One hundred and thirty-eight patients with EH and 86 normal controls were studied with echocardiography.According to left ventricular mass index (LVMI) and relative wall thickness (RWT),a total of 138 patients with EH were divided into normal geometry group (58 cases),concentric remodeling group (22 cases),concentric hypertrophy group (21 cases) and eccentric hypertrophy group (37 cases).Correlation between left atrial diameter index (LADI),left atrial ejection force (LAEF) and all parameters was respectively obtained using linear regression analysis,and the stepwise regression analysis was used to assess the independent effect of each parameter.Results Compared with control group,LADI and LAEF were higher ( P < 0.05 ) in four LV geometry patterns with EH.Correlation analysis showed that LADI was positively correlated with age,hypertension duration,body mass index (BMI),systolic blood pressure (SBP),LVMI,interventricular septal thickness (IVS),isovolumic relaxation time (IVRT) and E-peak deceleration time (EDT) ( P < 0.05 ),inversely correlated with E/A ratio (E/A) ( P < 0.05 ); LAEF was positively correlated with age,SBP,LVMI,IVS,IVRT and EDT ( P < 0.05 ),inversely correlated with E/A ( P < 0.01 ).Multiple stepwise regression analysis showed that LADI was independently correlated with LVMI,age,SBP,IVRT and EDT ( r = 0.481 , r 2 = 0.231 ),LAEF correlated with LVMI,IVRT and E/A ( r = 0.376 , r 2 = 0.141 ).Conclusions Increased LADI and LAEF appear before LV hypertrophy,and occur in EH with all LV geometrical patterns.LV hypertrophic geometry,age,SBP and LV diastolic parameters may be related to LA enlargement and increased systolic performance,and promote the changes of LA structure and function.更多还原