高血压患者左房容积标准化指标的初步研究

Preliminary study on the significance of standardized index for left atrial volume in hypertensive patients

目的:分析高血压患者左房容积常规指标及标化指标的变化,探讨各项指标与高血压程度及个体形体之间的关系。方法:选择60例高血压患者(1级、2级、3级各20例)和20例正常成人,分别用Simpson法和实时三维(real time three-dimensional、RT3D)容积法于收缩期末测量左房容积,得出Simpson法(LAVsimpson)左房容积和实时三维法(LAVRT3D)左房容积。用体表面积标化分别得出相应指数LAVisimpson和LAViRT3D,对比观察正常人和各级高血压患者上述4项指标的变化。结果:高血压1级的LAVsimpson和正常对照组比较无明显变化(P>0.05),高血压2级、3级的LAVsimpson与正常对照组之间的比较有差异(其中2级P<0.05,3级P<0.01)。高血压各级的LAVisimpson、LAVRT3D、LAViRT3D与正常对照组比较都有差异(P<0.05,其中高血压1级的LAVRT3DP<0.05,余指标P<0.01)。LAVisimpson、LAVRT3D、LAViRT3D在高血压各级之间的比较都有显著差异(P<0.01)。结论:各级高血压患者左房容积均表现增大,体表面积标化的LAVisimpson、LAViRT3D比未标化的LAVsimpson、LAVRT3D更早更敏感地反映高血压患者的左房容积变化。

Objective：To analyze the variation of conventional index and standardized index measured in the left atrial volume in hypertensive patients for estimation of the relationship between the index and severity of hypertension.Methods：Sixty hypertensive patients （stage 1,2 and 3,n=20 for each stage） and 20 healthy adults were included and measured with Simpon technique and real-time three-dimensional（RT3D） method for LAVsimpson and LAVRT3D. LAVisimpson and LAViRT3D index were obtained by standardized body surface area standardized,and compared for index change in hypertensive patients and healthy subjects.Results：LAVsimpson at stage-1 of hypertension remained no significant change as compared with the healthy controls（P〉0.05）,whereas LAVsimpson was varied significantly at stage-2 and 3 stage of hypertension（stage 2,P〈0.05;stage 3 P〈0.01）.LAVisimpson,LAVRT3D and LAViRT3D at all stages of hypertension were significantly different （P〈0.05）,in which the index were dominant by LAVRT3D at stage-1 of hypertension（P〈0.05） and residual parameters（P〈0.01）.LAVisimpson,LAVRT3D and LAViRT3D were also different by levels at different stage of hypertension（P 〈0.01）. Conclusion：Left atrial volume tends to increase in hypertensive patients at diverse stage,and standardized index for LAVisimpson and LAViRT3D may be more sensitive in predicting the severity of hypertension.