老年高血压患者心外膜脂肪厚度与左心房扩大的相关性研究

Study on the correlation between epicardial adipose tissue and left atrial enlargement in elderly hypertensive patients

目的探讨老年高血压患者心外膜脂肪(EAT)厚度与左心房扩大的相关性。方法选取2019年6月至2020年6月抚州市第一人民医院收治的160例老年高血压患者作为研究对象,根据左心房前后径是否扩大分为左心房扩大组与非左心房扩大组,每组80例。检测两组氨基末端脑钠肽前体(NT-proBNP)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、甘油三酯(triglyc-eride,TG)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、C反应蛋白(CRP)、载脂蛋白A1(apoA1)及载脂蛋白B(apoB)水平,采用多普勒超声心动图检测左心房内径(LAD)、室间隔厚度(IVS)、左室后壁厚度(LVPWT)、左心室舒张末期内径(LVEDD)、左心室舒张末期内径(LVESD)、左室质量指数(LVMI)、射血分数(EF),并计算二尖瓣舒张早期血流速度/二尖瓣舒张晚期血流速度(E/A)、E/舒张早期二尖瓣环运动速度(E/E’)。结果左心房扩大组EAT厚度厚于非左心房扩大组,LAD长于非左心房扩大组,NT-proBNP、CRP水平均高于非左心房扩大组,差异有统计学意义(P<0.05)。左心房扩大组HDL-C、apoA1水平均低于非左心房扩大组,HbA1c水平高于非左心房扩大组,差异有统计学意义(P<0.05)。左心房扩大组IVS、LVPWT、LVEDD、LVESD、LVMI、E/E’均高于非左心房扩大组,EF、E/A均低于非左心房扩大组,差异有统计学意义(P<0.05)。Pearson相关分析结果显示,EAT厚度与LAD、NT-proBNP、CRP、HbA1c、LVPWT、LVEDD、LVESD、E/E’均呈正相关(r>0,P<0.05),与HDL-C、apoA1、EF、E/A呈负相关(r<0,P<0.05)。结论老年高血压患者EAT厚度与左心房扩大具有一定的相关性,可作为评估老年高血压患者左心房扩大的辅助指标。

Objective To investigate the correlation between epicardial adipose tissue(EAT)thickness and left atrial enlargement in elderly pa-tients with hypertension patients.Methods 160 elderly patients with hypertension admitted to Fuzhou First People's Hospital from June 2019 to June 2020 were selected as the research subjects,they were divided into the left atrial enlargement group and the non-left atrial enlargement group ac-cording to whether the left atrial anteroposterior diameter was enlarged,with 80 cases in each group.The levels of N terminal pro B type natriuretic paptide(NT-proBNP),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),triglyceride(TG),fasting blood glucose(FBG),glycosylated hemoglobin A1c(HbA1c),C-reactive protein(CRP),apolipoprotein A1(apoA1)and apolipoprotein B(apoB)were detected,Doppler echocardiography was used to detect left atrial diameter(LAD),interventricular septal thickness(IVS),left ventric-ular posterior wall thickness(LVPWT),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventric-ular mass index(LVMI),ejection fraction(EF),and calculate the early diastolic mitral flow velocity/late diastolic mitral flow velocity(E/A),E/ear-ly diastolic mitral annulus velocity(E/E').Results The thickness of EAT in the left atrial enlargement group was thicker than that in the non-left atri-al enlargement group,the LAD was longer than that in the non-left atrial enlargement group,and the levels of NT-proBNP and CRP were higher than those in the non-left atrial enlargement group,the differences were statistically significant(P<0.05).The levels of HDL-C and apoA1 in the left atri-al enlargement group were lower than those in the non-left atrial enlargement group,and the level of HbA1c was higher than that in the non-left atrial enlargement group,the differences were statistically significant(P<0.05).IVS,LVPWT,LVEDD,LVESD,LVMI and E/E'in the atrial enlargement group were higher than those in the non-left atrial enlargement group,EF and E/A were lower than those in the non-left atrial enlargement group,and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that EAT thickness was positively correlated with LAD,NT-proBNP,CRP,HbA1c,LVPWT,LVEDD,LVESD and E/E'(r>0,P<0.05),and negatively correlated with HDL-C,apoA1,EF and E/A(r<0,P<0.05).Conclusion There is a certain correlation between EAT thickness and left atrial enlargement in elderly hypertensive patients,which can be used as an auxiliary index to evaluate left atrial enlargement in elderly hypertensive patients.