高血压患者的左室舒张功能与胰岛素样生长因子1

Left ventricular diastolic function and insulin-like growth factor-1 in patients with hypertension

目的:应用超声技术评价高血压患者左室舒张功能,并探讨其与胰岛素样类生长因子1的关系。方法:选择2003-06/2003-12齐鲁医院门诊及住院的单纯原发性高血压患者61例为高血压组。根据左室质量指数将患者分为左室心肌肥厚组30例和无心肌肥厚组31例。选择同期齐鲁医院门诊体检健康自愿者20例为对照组,男8例,女12例。脉冲波多普勒超声测量所有研究对象二尖瓣血流,根据二尖瓣瓣尖频谱测量舒张早期最大血流速度、晚期最大血流速度及其比值。多普勒组织成像测量二尖瓣环心肌舒张早期峰值运动速度、晚期峰值运动速度及其比值。所有研究对象均用放射免疫分析测定血清胰岛素样类生长因子1的浓度。结果:高血压患者二尖瓣瓣尖舒张早期、晚期最大血流速度比值明显小于对照组(P<0.01),左室心肌肥厚组二尖瓣瓣尖舒张早期最大血流速度/二尖瓣瓣尖晚期最大血流速度比值明显小于无心肌肥厚组(P<0.01);无心肌肥厚组、左室心肌肥厚组患者二尖瓣侧环心肌舒张早期峰值运动速度/心肌舒张晚期峰值运动速度比值(0.88±0.12,0.74±0.09)均小于对照组(1.42±0.11)(P<0.01);左室心肌肥厚组比值明显小于无心肌肥厚组(P<0.01)。无心肌肥厚组、左室心肌肥厚组患者血清胰岛素样生长因子1水平明显高于对照组(P均<0.001);左室心肌肥厚组血清?

AIM:To detect the left ventricular diastolic function with echocardiography in hypertensive patients,and investigate its correlation with insulin-like growth factor-1(IGF-1). METHODS:Sixty-one patients with essential hypertension(hypertension group),who were treated and hospitalized in the Qilu Hospital from June to December 2003,were divided into left ventricular hypertrophy group(n =30) and non-left ventricular hypertrophy group(n=31) according to their left ventricular mass index.Twenty healthy physical examinees at the same period were voluntarily selected as the normal controls(control group,8 males and 12 females).The pulsed Doppler was used to measure the flow speed of bicuspidal valve of all the subjects,the maximal blood flow velocity at early diastolic period and that at late diastolic period,as well as the ratio of the blood flow velocity at early diastolic period to that at late diastolic period were measured with the mitral tip spectrum.The peak motion velocity at early diastolic period and that at late diastolic period,as well as the ratio of the peak motion velocity at early diastolic period to that at late diastolic period in myocardium of mitral ring were determined with Doppler tissue image.The serum concentration of IGF-1 was measured by radioimmunology in all the subjects. RESULTS:The ratio of the blood flow velocity at early diastolic period to that at late diastolic period was obviously smaller in the hypertension group than in the control group(P< 0.01),also obviously smaller in the left ventricular hypertrophy group than in the non-left ventricular hypertrophy group(P< 0.01);The ratio of the peak motion velocity at early diastiolic period to that at late diastolic period in the left ventricular hypertrophy and non-left ventricular hypertrophy groups(0.88±0.12,0.74±0.09) were markedly smaller than that in the control group(1.42±0.11)(P< 0.01),and it was also remarkably smaller in the left ventricular hypertrophy group than in the non-left ventricular hypertrophy group(P< 0.01).The non-left ventricular hypertrophy and left ventricular hypertrophy groups had more significant higher IGF-1 levels than the control group(P< 0.001),and it was more higher in the left ventricular hypertrophy group than in the non-left ventricular hypertrophy group(P< 0.01).IGF-1 was significantly and negatively correlated with ratio of the peak motion velocity at early diastolic period to that at late diastolic period and side ring ratio of the peak motion velocity at early diastiolic period to that at late diastolic period (r=-0.65,-0.61,P< 0.01). CONCLUSION:IGF-1 has better correlation with left ventricular diastolic function assessed by echocardiography.