高血压患者左心房内径变化的临床意义

The clinical significance of the alteration of the internal diameter of left atrium in hypertension patients

目的探讨原发性高血压病左心房内径变化及临床意义。方法对照组20例,高血压病左心室心肌质量指数(LVMI)正常组35例,高血压病左心室肥厚(LVH)组30例。用超声心动图测量三组左心房内径(LAD)、室间隔厚度(IVST)、左心室后壁厚度(LVPWT)、左室射血分数(LVEF)、左室质量指数(LVMI)、左房室瓣E峰和A峰最大流速比值(E/A),测定静息心率(RHR)并进行对比分析。结果与对照组对比,高血压LVMI正常组LAD扩大较显著(P<0.05),而IVST、LVPWT、LVMI、E/A、LVEF及RHR无显著变化(P>0.05)。与对照组相比,高血压病LVH组LAD扩大更显著(P<0.01),IVST、LVPWT、LVMI、E/A、LVEF及RHR均有显著改变(P<0.05)。结论在高血压病早期IVST、LVPWT、LVMI、E/A、LVEF及RHR尚无明显异常时,已出现LAD扩大。提示LAD扩大是高血压病心脏受损的最早期表现,比左心室肥厚及E/A<1更有临床意义。

Objective To investigate the clinical significance of the alteration of left atrium diameter in hypertension patients. Methods Among 85 hypertension patients,65 cases were selected from the patients of our hospital. 20 healthy subjects were also included in our study. Ultrasonography imager was used to measure the internal diameter of left atrium（LAD）, septal thickness（ IVST）, left ventricular posterior wall thickness（ LVPWT）, left ventricular ejection fraction（LVEF）,left ventricular mass index（ LVMI）, E/A ratio and rest heart rate（RHR） for the analysis among them. Results LAD significantly enlarged in hypertension and normal LVMI patients compared with that of the control group（ P 〈 0.05） ,but the IVST, LVPWT, LVMI ,E/A, LVEF and RHR had no significant difference between the two groups. LAD more significantly increased in hypertension and LVH patients compar＆l with that of the control group（ P〈 0 . 01 ）, and the IVST, LVPWT, LVMI, E/A, LVEF and RHR had significant difference between the two groups（ P 〈 0. 05 ）. Conclusion The LAD enlarge before the abnormity of IVST. LVPWT,LVMI ,E/A, LVEF and RHR in those patients with hypertension. LAD enlargement might be a earlier marker of the damage of myocardium in the development of hypertension,and has more clinical significance than left ventricular hypertrophy and E/A〈 1.