高血压左心室肥厚相关因素的探讨

A study of related factors on left ventricular hypertrophy due to essential hypertension

目的 分析２０１ 例高血压者临床和超声心动图资料，旨在探讨左心室肥厚（ＬＶＨ） 的相关因素。方法 应用超声心动图测量ＩＶＳＴ、ＰＷＴ、ＬＶＤ、ＬＡＤ、Ａ峰、Ｅ峰、Ｅ／Ａ 比值，以左心室重量指数（ＬＶＭＩ） 作为诊断ＬＶＨ 的指标。结果 ＬＶＨ 检出率２０．９ ％ ，男女性之间无显著性差异，如仅凭ＩＶＳＴ 和ＰＷＴ≥１１ｍ ｍ 作为诊断ＬＶＨ 的标准，其阳性率９２ ．９％ ，假阴性率７ ．１％ ，假阳性率３２．１ ％ ；ＬＶＨ类型以对称性肥厚为主占９２ ．９％ 。ＬＶＨ组的年龄、高血压病程与ＮＬＶＨ 组有显著性差异（ Ｐ＜０ ．０１） ；ＬＶＨ 组ＬＡ扩大占５７ ．１％ ，Ｅ／Ａ缩小占１００ ％ ，与ＮＬＶＨ 组相比有显著性差异（Ｐ＜０ ．０１）；ＮＬＶＨ 组其ＩＶＳＴ、ＰＷＴ 及ＬＶＭＩ与正常组相比有显著性差异（ Ｐ＜ ０．０１） 。结论 以ＬＶＭＩ作为诊断ＬＶＨ 的标准较为准确、可靠，年龄、高血压病程是影响ＬＶＨ的一个重要因素，ＬＶＨ 伴ＬＡ 扩大和左室舒张功能下降，可出现在ＬＶＨ 之前，ＮＬＶＨ者较正常人其左心室重量增加。

Objectives To analyze clinical and echocardiographic data in patients with essential hypertension in order to study related factors of left ventricular hypertrophy(LVH).Methods Such parameters as IVST,PWT,LVD,Peak A, Peak E, and E/A were measured in echocardiography.Left ventricular mass index(LVMI) was used as a diagnostic standard for LVH.Results The prevalence of LVH was 20.9%, No significant difference between male and female.If IVST and PWT≥11mm was used as a diognostic standard, the positive rate was 92.9%,false positive rate reached 32.1% and false negative rate was 7.1%,In all types of LVH, cocerntric Hypertrophy (CH) was 92.9%.There was significant difference in ages and duration betweenLVH group and NLVH group(P<0.01).The propertion of enlarged LA was 57.1% and decreased E/A was 100% which showed significant difference to NLVH group(P<0.01).Parameters IVST,PWT and LVMI in NLVH group also showed significant difference to control group. Conclusions It was more accurate and reliable to use LVMI as a diagnostic standard for LVH.Age and duration of hypertension were important related factors which affect development of LVH.