高血压前期人群左心室结构和功能的临床研究

Study on the features of left ventricular structure and function in pre-hypertension

目的了解高血压前期人群的左心室结构和功能特点。方法依据美国预防、检测、评估与治疗高血压联合委员会第7次报告对高血压进行的重新分类,按血压水平分为:血压正常组(normotension,NTN 组)75例,高血压前期组(pre—hypertension,PHT组)124例,高血压组(hypertension,HTN组)195例,应用超声心动图检测他们的左心室结构和功能。结果 HTN组与NTN组和PHT组舒张末期室间隔厚度、舒张末期左心室后壁厚度、左心室壁相对厚度、左心室质量及左心室质量指数的差异有统计学意义,其中HTN组与NTN组之间的差异有统计学意义(P<0．01),而PHT组与NTN组的差异无统计学意义;左心室功能随血压水平的升高而减退,但3组之间舒张功能的差异无统计学意义(P>0．05),而收缩功能的差异有统计学意义(P<0．05),其中HTN组与NTN组之间的差异有统计学意义(P<0．01)。结论高血压前期人群可出现心脏结构和功能的改变,随血压水平的升高,其收缩功能的损害更为突出,左心室结构的改变更为明显。

Objectives To study the features of left ventricular structure and function in the prehypertensive people. Methods Subjects were divided into three groups according to blood pressure status using the JNC-7 criteria. We measured the left ventricular configuration and function by means of echocardiography in 75 normotension （NTN） people, 124 pre-hypertension （PHT） people and 195 hypertension （HTN） patients. Rusults The IVSTD, LVPWTD, RWT, LVM and LVMI of hypertension group were significantly increased as compared with those of NTN group （P〈0.01） and pre-hypertension group （P〈 0.05）. The systolic and diastolic functions were both impaired in the PHT group and HTN group （P〉 0.05）, but the comparison between these two groups showed that significant difference was noted only in FS （P〈0.05）. Conclusions The heart structure and function can be impaired in pre-hypertension. The higher the blood pressure increases, the more severe will be the impairment of systolic function, and the more prominent will be the change in left ventricular structure.