腹型肥胖对原发性高血压患者左室肥厚的影响

Influence of abdominal obesity on left ventricular hypertrophy in patients with essential hypertension

[目的]探讨腹型肥胖对原发性高血压患者左室肥厚的影响。[方法]根据亚太地区腹型肥胖的界定标准(男>90 cm,女>80 cm),选择102例原发性高血压腹型肥胖患者及84例非肥胖患者,测定所有患者空腹血糖(FPG)、血清总胆固醇(Tch)、甘油三脂(TG)、高密度脂蛋白胆固醇(HDL)、低密度脂蛋白胆固醇(LDL)及超声心动图的各种参数,计算左室重量指数(LVM I)。入选患者排除糖尿病、继发性高血压、缺血型心肌病、脑血管疾病、肝肾功能不全、心衰(NYHAⅡ、Ⅲ)。[结果]①高血压合并腹型肥胖组患者舒张末期左室内径(LVEDd)、舒张末期室间隔的厚度(IVSd)、舒张末期左室后壁的厚度(LVPW d)、左室重量指数(LVM I)均明显高于非肥胖组,两组差异有显著的统计学意义(P<0.01)。②高血压合并腹型肥胖组患者左室肥厚(LVH)的发生率明显高于非肥胖组(20.1%VS10.6%),两组差异有显著的统计学意义(P<0.05)。③逐步多元线性回归分析显示:除血压外,只有腹围与LVM I独立相关。[结论]腹型肥胖对高血压左室肥厚有显著的影响。除血压外,腹围是左室肥厚的一个独立预测因子。

[ Objective] To evaluate the influence of abdominal obesity on the left ventricular hypertrophy in essential hypertensive patients. [Methods] A total of 186 essential hypertensives were included and routine physical examination and blood chemistry, including blood pressure, waist circumference, fasting glucose, total cholesterol, triglycerides, HDL -cholesterol and LDL - cholesterol were performed. According to the definition of abdominal obesity ： waist circumference 〉 90 cm in men or 〉 80 cm in women, there were 102 patients with abdominal obesity and 84 patients without abdominal obesity. All parameters provided by echocardiography examination were detected and left ventricular mass index （LVMI） were calculated, respectively. Those cases with diabetes mellitus, secondary hypertension, ischacmic heart disease, cerebrovascular disease or heart failure were excluded in this study. [ Results ] （1）Compared with isolated hypertensive patients, hypertensive patients with abdominal obesity exhibited more elevated parameters including end -diastolic left ventricular internaldimension （ LVEDd）, end - diastolic interventricular septum thickness （ IVSD）, end - diastolic posterior wall thickness （LVPWd） and left ventricular mass indexed （LVMI） （P 〈0.05） ; （2）In comparison with the group of isolated hypertensive patients, hypertensive patients with abdominal obesity showed significantly higher ratio of LVH （ 20. 1% vs 10.6% ,P 〈 0.01 ） ; （3）Stepwise multiple linear regression analysis showed that the parameter of waist circumference was independently related to the left ven- tricular mass index （LVMI）. [ Conclusion] Abdominal obesity is associated with left ventricular hypertrophy （LVH） in essential hypertensive patients. Waist circumference is one of independent risk factors of LVH.