原发性高血压患者动脉僵硬度与左室舒张功能的相关性

Relationship Between Arterial Stiffness and Left Ventricular Diastolic Function in Essential Hypertensive Patients

【目的】探讨高血压患者动脉僵硬度与其左室舒张功能状态的相关性。[方法]80例确诊高血压患者作为观察组，年龄范围42～85岁，其中l级20例，2级38例，3级22例，另选择与观察组性别、年龄匹配的健康体检者作为对照组。采用肱动脉一踝动脉脉搏波传导速度（BaPWV）作为反映动脉僵硬度的指标。同时测定心脏舒张功能：用血流频谱模式，记录二尖瓣舒张期血流频谱，记录舒张早期血流峰值（E）和舒张晚期血流峰值（A）；切换组织多普勒模式，记录舒张早期峰值速度（Era）、舒张晚期峰值速度（Am），计算E／Em比值；比较高血压患者与对照组间BaP—WV与E／Em比值的关系。【结果】在调整了年龄、性别参数之后，分析结果显示：与对照组比较，观察组BaPWV值增加，差异有统计学意义（P〈0．05）；与对照组比较，高血压组E／Em比值明显增高，差异有统计学意义（P〈0．01），E／Era与BaPWV值呈显著正相关（r=0．29，P〈O．05）。【结论IBaPWV所反映的动脉僵硬度增加在高血压患者中与左室舒张功能状态恶化相关，改善动脉僵硬度可能对于改善高血压患者的舒张功能有益。

[Objective]To explore the relationship between arterial stiffness and left ventricular diastolic func- tion in essential hypertensive patients. [Methods] Eighty patients diagnosed as hypertension were chosen as obser- vation group（aged 41-85 years old） including 20 grade I cases, 38 grade II cases and 22 grade III cases. Other sex- and age-matched healthy subjects in observation group were chosen as control group. Brachial-ankle pulse wave ve- locity（baPWV） was used as the indicator of arterial stiffness. Meanwhile, cardiac diastolic function was measured. Blood flow spectral mode was used to record blood flow spectrum in diastolic period of mitral valve. Early diastolic flow peak（E） and late diastolic flow peak（A） were recorded, Tissue Doppler mode was switched. Early diastolic peak velocity（Em） and late diastolic peak velocity（Am） were recorded. E/Em ratio was calculated. The relation- ship between BaPWV and E/Em ratio was compared between hypertensive patients and controls. [Results] After the adjustment of age and sex parameters, the results showed that BaPWV in observation group increased in com- parison with control group, and there was significant difference（ P 〈0.05）. Compared with control group, the ra- tio of E/Era in hypertension group obviously increased, and there was significant difference（ P 〈0.01）. The ratio of E/Era had significantly positive relation with BaPWV（r= 0.29, P 〈0.05）. [Conclusion] The increasing of arte- rial stiffness assessed by BaPWV in hypertensive patients is associated with left ventricular dysfunction. Ameliora- ting arterial stiffness may be helpful for the improvement of diastolic function of hypertensive patients.