老年冠心病和高血压病患者左心房射血力改变及意义

Variation and Significance of Left Atrial Ejection Force in Elder Patients With Coronary Heart Disease and Hypertension

目的：应用多普勒超声心动图测定老年冠状动脉粥样硬化性心脏病（冠心病）及高血压患者左心房的充盈、射血力、径线和功能，以探讨其改变的临床意义。方法：基于牛顿运动第二定律，利用二尖瓣口处的血流多普勒及左心房结构的二维超声资料，检测年龄大于６０岁的１０２例受检对象，其中１９例健康者，２５例心绞痛者，１５例陈旧性心肌梗死者及４３例高血压者。结果：患者组左心房射血力、经二尖瓣口Ａ峰速度、左心房收缩末及舒张末面积均显著大于健康对照组（Ｐ值分别为＜０．００１，＜０．０１，＜０．００１及＜０．００１）。结论：老年高血压和冠心病患者左心房容量增大，左心房主动收缩功能增强。评价左心房收缩功能，左心房射血力的引入是一种新的、较准确和测定时较简便的生理指标。

Objectives:Left atrial dimension and function,as well as its ejection force and filling in elder patients with coronary heart disease and hypertension was evaluated by Doppler echocardiography. Methods:One hundred and two subjects over 60 years of age,including 19 controls;25,15 and 43 patients with angina pectoris,old myocardial infarction and hypertension,respectively were studied by Doppler echocardiolgraphy based on Newtons second law of motion at rest. Results:Compared with the control group,the left atrial ejection force and transmitral peak A wave velocity of the patient groups were greater and also the left atrial area at end systole and diastole were significantly enlarged( p <0.001,<0.01,<0.001,and <0.001,respectively). Conclusion:Left atrial ejection force is a new index for assessing the atrial systolic function,as in elder patients with coronary heart disease and hypertension the left atrium is enlarged with increased contractile function.