高血压病大动脉扩张性与左室肥厚关系的探讨

Study of relationship between large artery distensibility and left ventricular hypertrophy in patients with essential hypertension

目的 探讨高血压病 (essentialhypertension ,EH)患者大动脉扩张性降低与左室肥厚的关系。方法 分别应用脉搏波传导速度自动测量系统和超声心动图对颈动脉 股动脉脉搏波传导速度(pulsewavevelocity ,PWV)和左室结构进行观察。PWV为评价大动脉扩张性的指标 ;室间隔厚度 ,左室后壁厚度 ,左室重量指数作为评价左室肥厚的指标 ;左室相对厚度 ,即室间隔与左室后壁厚度之和与左室舒张末径之比用于评价左室向心性重塑。结果 PWV在左室肥厚组明显高于无肥厚组[(11 5 2± 2 45 )m/s :(10 80± 1 95 )m/s,P =0 0 0 13]。左室发生向心性重塑者与未发生重塑者相比PWV差异无显著性 [(11 10± 2 310 )m/s:(10 99± 1 99)m/s ,P =0 6 816 ]。结论 左室肥厚的EH患者大动脉扩张性显著降低 。

Objective To evaluate the relationship between large artery distensibility and left ventricular hypertrophy in hypertension. Methods Automatic pulse wave velocity (PWV) measurement system and two dimensional echocardiography were applied to examine carotid femoral PWV and left ventricular structure respectively. PWV was used as an index to reflect large artery distensibility; interventricular septal thickness, left ventricle posterior wall thickness, and left ventricular mass index were defined as indices for left ventricular hypertrophy; relative left ventricle thickness as an index to evaluate left ventricular concentric remodeling. Results PWV was higher in patients with left ventricular hypertrophy than that in patients without left ventricular hypertrophy (11 52±2 45 m/s vs 10 80±1 95 m/s, P = 0 001 3). There were no significant difference in PWV between patients with left ventricular concentric remodeling and without left ventricular concentric remodeling (11 10± 2 31 m/s vs 10 99±1 99, P = 0 681 6). Conclusion Large arterial distensibility decreased in patients with left ventricular hypertrophy in hypertension. The decreased large artery distensibility was an important factor that led to left ventricular hypertrophy in patients with essential hypertension.