运动平板试验评价原发性高血压左心室肥厚患者的心脏储备功能

EVALUATION OF THE CARDIAL RESERVE FUNCTION OF AN ESSENTIAL HYPERTENSION PATIENT WITH LVH BY EXCERCISE TRADMILL TEST

目的：应用运动平板试验评估原发性高血压左室肥厚患者的心功能及储备能力。方法：将运动试验后的２６例高血压患者分为阳性组１４例，阴性组１２例，分别测定ＬＶＥＦ、ＭＥＴｓ，并计算最大氧摄取量（ＶＯ＿（２ｍａｘ））；应用冠脉造影了解阳性组冠脉病变状况。采用ｔ检验处理数据。结果：（１）伴冠状动脉狭窄双支病变者，ＭＥＴｓ４．２～５．２，ＶＯ＿（２ｍａｘ）１４．２～１５．６ｍｌ·ｋｇ￣（－１）·ｍｉｎ￣（－１），ＬＶＥＦ平均４８％，均明显低于单支病变组及非冠状动脉狭窄组；（２）运动试验后阳性组收缩压及心率增加不如阴性组明显。结论：高血压左心室肥厚伴冠状动脉狭窄时心功能及储备功能明显下降，且随冠状动脉狭窄程度加重而加重，说明高血压左心室肥厚伴冠状动脉狭窄较非冠状动脉狭窄者更具有危险性。

Objective:To evaluate the cardial reserve function of an essential hypertension patient with left ventricular hypertrophy(LVH)by exercise treadmill test.Methods:26 patients with LVH were dev-ided into a positive group(n=14) and a negative group(n=12)according to the test result.Left ventric-ular ejection fraction(LVEF)and metabolic equivalents(METs)were measured and the maximal oxy-gen-uptaking volume(VO_(2max)) was calculated.The lesions of coronary arteries of the positive group were evalutqted by coronary angiography. The data were analysized by t test. Results:1.With double-vessel lexions existing,METs 4.2～5.2.VO_(2max) 14.2～15.6ml· kg￣(-1)· min￣(-1),mean LVEF 48%, all indices were significantly lower than those single-vessel lesion group and non-CAS group.2.After excercise test,the increase of SBP and HR of the positive group was not as significant as that of the negative group.Conclusion:In patients suffering from essential hypertention with LVH, if CAS exists,his myocardio function and reservebility extremely decreased,and the more serious the CAS.the lower the cardiofunction and reservebility,demostrating it′s more critical with CAS than without CAS in es-sential hypertension patient with LVH.