原发性高血压患者右心功能与肺功能的相关性研究

The correlation between right ventricular function and lung function in patients with essential hypertension

目的探讨原发性高血压（EH）患者右心功能与肺通气功能的相关性。方法①右心功能测定：对60例EH患者和对照组20例在二维超声心动图（2DE）上用改良Simpson法计算右室收缩功能。先测出整个心室的心腔容积（Vvl，含室间隔）及室间隔与左心室腔所占的容积（Vlvivs），两者相减即可得出右心室腔的容积（RVV，RVV=Vvl—Vlvivs）。测算右心功能指标：右心室射血分数（RVEF）、右室每搏输出量（RVSV）、右心室心输出量（RVCO）等。②所有受检者行肺通气功能检测，结果与RVEF进行相关分析。结果①右心功能测定结果：与对照组相比，各级EH患者右室收缩功能均有不同程度减低，而以3级高血压较显著（RVEF分别为68．16±6．26和48．94±6．09，P〈0．01）。②肺功能结果：EH各组肺功能指标较对照组均降低，但仅与2、3级组间的差异有统计学意义；与1级组相比，2级组用力肺活量（FVC）、第1秒用力呼气量（FEV1）降低；3级组中FVC、FEV1、最大呼气中段流量（MMEF）、肺总量（TLC）均降低（P〈0．05或P〈0．01）；EH3级组中FVC较2级组降低（2．04±0．27比2．39±0．45，P〈0．01）。③RVEF与FVC、FEV1、MMEF、MVV、TLC测值间的相关系数分别为0．93、0．91、0．59、0．51和0．77，提示RVEF主要与FVC、FEV1呈正相关（P〈0．01）。结论①EH患者右室收缩功能减低，以3级高血压较显著。②EH患者存在肺通气功能的损害，并随血压分级的加重而呈减低趋势。③EH患者RVEF与肺通气功能指标的变化可能存在一定的相关性。

Objective To investigate the correlation between fight ventricular function and lung ventilation function in patients with essential hypertension. Methods （1） Measurement of right heart function： check in apical four chamber view of 2DE on 60 patients with essential hypertension and 20 cases control group. Total ven- tricular volume （Vvl）（include interventricular septum）and Vlvivs （volume of interventrieular septum and left ventricular）, were measured and calculated by ameliorate Simpson method, and then the fight ventficular volume was calculated（ RVV=Vvl-Vlvivs ）. Ventricular volume was measured by mentioned method in end systole and end diastole which can calculate right heart function indexs. （2） The lung function was checked in all examinees and the results were obtained are analyzed comparatively with the RVEF. Results （1） Right ventricular function：fight ventrieular function in patients with essential hypertension was decrease. （2） Lung function indexs in each EH group were lower than that of control group, but there was difference on stage Ⅱ and stage Ⅲ. compared with stage Ⅰ , and FVC, FEV1 was decreased in stage Ⅱ , FVC,FEV1 ,MM EF,TLC were decreased in stage Ⅲ （P〈0.05 or P〈 0.01 ）. FVC in stage Ⅲ was lower than that of stage Ⅱ （2.04±0.27 vs 2.39±0.45 ）（P〈0.01 ）. （3） Relative coefficient in RVEF and FVC,FEV1,MM EF,MVV,TLC was 0.93, 0.91, 0.59, 0.51, 0.77 respectively. There were main positive correlation within RVEF and FVC, FEV1 （P〈0.01）. Conclusion （1） Right ventfieular function in patients with essential hypertension is decrease. （2） There is damaged of lung ventilation function in patients with essential hypertension which aggravate with increase of blood pressure level.（3） There is correlation between RVEF and lung ventilation function in patients with essential hypertension.