【摘要】 目的:探讨血清D-二聚体(D-D)与老年原发性高血压(EH)患者左室肥厚的相关性。方法:选取我院收治的老年EH患者158例为研究对象,均行心脏超声检查,依据左室质量指数(LVMI)将患者分为左室肥厚组(LVH组,n=72例)和非左室肥厚组(非LVH组,n=86例);分析比较两组患者血清D-D水平及相关实验室检查指标的差异。用Logistic回归模型分析血清D-D水平与左室肥厚的关系,用ROC曲线分析血清D-D水平预测老年EH患者发生左室肥厚的价值。结果:LVH组患者血清D-D水平[(315.54±45.70)μg/L]高于非LVH组[(148.29±37.65)μg/L](t=13.456,P<0.05);D-D增高组患者LVMI[(137.25±16.94)g/m~2]高于非LVH组[(104.39±14.84)g/m~2](t=12.876,P<0.05);D-D增高组中有发生左室肥厚的比例显著高于D-D正常组(65.1%vs 38.3%,X2=4.567,P<0.05)。血清D-D与LVMI呈正相关(r=0.354,P<0.05),与NT-pro BNP亦呈正相关(r=0.394,P<0.05)。血清D-D水平(OR=1.239,95%CI:1.134~1.548,P<0.05)是老年EH发生左室肥厚呈的独立相关因素。血清D-D预测发生左室肥厚的曲线下面积(ROCAUC)为0.879;灵敏度及特异度分别是89.8%及78.7%,最佳诊断截点为295.54μg/L。结论:老年EH患者血清D-D水平可能是左室肥厚发生的独立危险因素,血清D-D指标对于评价高EH患者左室肥厚的发生具有一定的临床意义。更多还原

【Abstract】 Objective: To investigate the correlation of serum D-dimer(D-D) and left ventricular hypertrophy in elderly patients with primary high blood pressure(EH). Methods: Select 158 cases of elderly EH patients in our hospital as the research objects. All patients had cardiac ultrasound, and were divided into left ventricular hypertrophy group(LVH group, n=72) and non-left ventricular hypertrophy group(non-LVH group, n = 86) according to the left ventricular mass index(LVMI). Detect their serum D-D levels and related laboratory examination indexes, and compare the difference between the two groups. Then Logistic regression model was applied to analyze the relationship between serum D-D level and left ventricular hypertrophy. ROC curve was used to analyze the value of serum D-D levels in predicting left ventricular hypertrophy for elderly patients with EH. Results: The serum D-D level of LVH group [(315.54 +45.70) μg /L] was higher than that of the non-LVH group [(148.29 + 37.65) μg /L](t = 13.456, P < 0.05). The LVMI of D-D increased group(137.25 + 16.94) g/m~2 was higher than that of the non-LVH group(104.39 + 14.84) g/m~2(t = 12.876, P < 0.05). The ratio of left ventricular hypertrophy cases in D-D increased group was significantly higher than in D-D normal group(65.1% vs 38.3%, chi-square =4.567, P< 0.05). The serum D-D was positively correlated with LVMI(r = 0.354, P < 0.05), and also positively correlated with NT-pro BNP(r = 0.394, P < 0.05). The serum D-D level(OR = 1.239, 95% CI: 1.134 ~ 1.548, P < 0.05) was independent factor of left ventricular hypertrophy for elderly EH. Its predict occurrence area under the curve of the left ventricular hypertrophy(ROCAUC) was0.879, and the sensitivity and specificity rate was 89.8% and 78.7% respectively, the best diagnostic cutoff point was 295.54 μg/L.Conclusions: Serum D-D levels may be independent risk factors of left ventricular hypertrophy for elderly EH patients. Serum D-D indicators have clinical significance in assessment of left ventricular hypertrophy for patients with high EH.更多还原