高血压病对心脏左心房构型及功能的影响

Effects of hypertension on left atrial structure and function evaluated by ultrasonic acoustic quantification

目的 探讨 86例高血压病患者左心房构型及左心房功能的变化 ,以及年龄、性别、高血压病程、高血压分期和左室功能的变化对其左心房构型和左心房功能的影响。方法 利用超声声学定量技术评价高血压病患者左心房及左心室功能。结果 ①与 80例正常对照者相比 ,86例高血压病患者的左心房增大 ,左心房收缩与舒张功能较正常对照者明显减低 (P <0 .0 0 1)。②性别对高血压病患者左心房构型及左心房功能无影响。随着年龄的增大 ,高血压病患者左心房逐渐增大 ,左心房收缩功能逐渐减低。③高血压病程对高血压病患者左心房构型及左心房功能无影响。④高血压病患者左心房构型及左心房功能随着高血压程度的加重而变化 ,即Ⅱ期高血压病患者的左心房较Ⅰ期高血压病患者增大 (均P <0 .0 5 ) ;Ⅱ期高血压病患者的左心房舒张功能较Ⅰ期高血压病患者减低 ( P <0 .0 1) ;Ⅲ期高血压病患者的左心房较Ⅰ期、Ⅱ期高血压病患者增大 (均P <0 .0 5 ) ;Ⅲ期高血压病患者的左心房收缩与舒张功能较Ⅰ期、Ⅱ期高血压病患者减低 (均P <0 .0 5 )。⑤高血压病患者左心房构型及左心房收缩功能的变化与左心室舒张功能有显著相关性 (r分别为 -0 .63、-0 .71,均P <0 .0 1) ,左心室舒张功能的减低可导致左心房增大 ,左心房收缩功能下降。

Objective To explore left atrial(LA) structure and function changes in 86 cases of essential hypertension disease (EH) and effects of age,gender,hypertension duration,hypertension stage and left ventricular function on them.Methods Using M mode echocardiogram to detect LA diameter, Using ultrasonic acoustic quantification (AQ) to detect LA area,LA systolic and diastolic function,LV systolic and diastolic function. Results ①Compared with normal group, LA diameter and LA area were larger in EH group, LA systolic and diastolic function were impaired. ② Gender had no effect on LA structure and functione in EH patients; LA diameter and LA area dilated with age, LA systolic function was impaired with age. ③ Hypertension duration had no effect on LA structure and function in EH patients. ④LA diameter and area dilated with hypertension stage. With the development of hypertension, LA diastolic function was first impaired,then LA systolic function was also impaired.⑤LA structure and function had signifficant relationship with LV diastolic function, LA might dilate and LA systolic function might be impaired with LV diastolic function damage.Conclusions LA diameter and LA area are dilated and LA function is impaired in EH patients, which changes become more signifficant with age. LA structure change and systolic function impairment have a relationship with LV diastolic dysfunction.