高血压病颈动脉硬化痰湿证患者左室重构的变化

Changes of Left Ventricular Remodeling in Hypertension Patients with Carotid Atherosclerosis of Phlegm-Dampness Syndrome

目的研究高血压病颈动脉硬化(carotid atherosclerosis,CAS)痰湿证患者左室重构的变化。方法观察高血压病CAS患者223例(痰湿证组119例、非痰湿证组104例,高血压病CAS组)、非高血压病CAS患者81例(非高血压病CAS组)和非高血压非CAS患者19例(对照组)的心脏多普勒超声检查结果,比较各组发生左室重构程度的差异。结果高血压病CAS组的左室后壁厚度(left ventricular posterior wall thickness,LVPWT)、舒张末期室间隔厚度(inter ventricular septum thickness,IVS)、二尖瓣快速充盈期与心房收缩期血流速度比值(E/A)高于非高血压病CAS组(P<0.05)。高血压病软斑组及非高血压病软斑组的左室舒张末期内径(left ventricular end-diastolic dimension,LVEDD)、左室收缩末期内径(left ventricular end-systolic diameter,LVESD)、每搏出量(stroke volume,SV)高于硬斑组、内膜增厚组和内膜正常组,差异有统计学意义(P<0.01,P<0.05)。高血压病痰湿证组的LVEDD、LVESD、SV高于高血压病非痰湿证组(P<0.05),左室射血分数(ejection fraction,EF)低于高血压病非痰湿证组(P<0.05),其中软斑组的LVEDD、LVESD、SV高于硬斑组(P<0.01)、内膜增厚组(P<0.01)和内膜正常组(P<0.05)。高血压病非痰湿证软斑组与硬斑组的比较差异无统计学意义(P>0.05)。结论高血压病痰湿证患者的CAS可能与左室重构有关,特别是软斑组患者,其左室重构更为明显。

Objective To study changes of left ventricular remodeling （LVR） in hypertension pa- tients with carotid atherosclerosis （CAS） of phlegm-dampness syndrome （PDS）. Methods Color Doppler ultrasonography data of CAS were observed in 223 hypertension patients with CAS （as the hypertension group, including 119 patients of the PDS group and 104 of the non-PDS group）, 81 CAS patients with non-hypertension, and 19 non-hypertension non-CAS patients （as the control group）. The difference in the degree of LVR was compared among the above groups. Results The left ventricular posterior wall thickness （LVPWT）, inter ventricular septum thickness （IVS）, E/A were higher in the hy- pertension group than in the non-hypertension group （P 〈0.05）. The left ventricular end-diastolic dimen- sion （LVEDD）, left ventricular end-systolic diameter （, LVESD）, stroke volume （SV） were higher in the soft plaque hypertension group and the soft plaque non-hypertension group than in the hard plaque group, the thickening intimal group, and the normal intimal group （P 〈0.01 ,P 〈0.05）. The LVEDD, LVESD, and SV were higher, and the ejection fraction （EF） was lower in the PDS hypertension group than in the non- PDS hypertension group （all P〈0.05）. Of them, LVEDD, LVESD, and SV were higher in the soft plaque group than in the hard plaque group （P 〈0.01 ）, the thickening intimal group （P 〈0.01 ）and the normal intimal group （P 〈0.05）. There was no statistical difference in PDS hypertension between the soft plaque group and the hard plaque group （P 〉 0.05）. Conclusion The hypertension patients with CAS of PDS might be correlated to LVR, and LVR was more obviously in the soft plaque patients.