原发性高血压患者升主动脉弹性与左心室扭转相关性研究

Analysis of associations between arterial elasticity and left ventricular twist in patients with essential hypertension

目的探讨原发性高血压患者升主动脉弹性与左心室扭转的相关性。方法选择我院2014年10月至2015年6月收治的原发性高血压患者60例作为高血压组，并选择同期在我院进行健康查体者60例作为健康对照组，均行SBP、DBP、脉压差（PP）的测量，利用超声技术检测升主动脉收缩期内径、舒张期内径，计算主动脉应变（AS）、主动脉僵硬度（13）和扩张性（AD），利用斑点追踪技术检测左心室基底段旋转角度（PBR）、心尖段旋转角度（PAR），并计算左心室整体扭转角度峰值（Ptw）。结果高血压组患者的B为3．99±0．43、PP为（74．2±10．4）mmHg、Ptw为（21．73±2．30）°，健康对照组分别为2．75±0．27、（45．9±5．1）mmHg、（14．04±2．90）°，两组比较差异均有统计学意义（P值均为0．000）。高血压组患者AS为0．034±0．012、AD为1．00±0．47，健康对照组分别为0．106±0．028、4．69±1．37，两组比较差异均有统计学意义（P值均为0．000）。Pearson相关分析显示，β与PBR、PAR、Ptw均呈显著正相关，相关系数分别是0．361、0．719、0．730，P〈0．01或P〈0．05；AD与PBR、PAR、Ptw呈显著负相关，相关系数分别是-0．279、-0．625、-0．610，P〈0．01或P〈0．05。结论原发性高血压患者升主动脉僵硬度、脉压差、左心室整体扭转角度较高，而主动脉应变、升主动脉扩张性均较差，且升主动脉僵硬度及扩张性与左心室基底段旋转角度、心尖段旋转角度、左心室整体扭转角度相关。

Objective To investigate the relationship between arterial elasticity and left ventricular twist in patients with essential hypertension （ EH）. Methods Sixty patients with EH who were treated in the First Affiliated Hospital of the Medical College of Shihezi University from October 2014 to June 2015 as the EH group, and 60 healthy persons in the same period as the control group. The systolic blood pressure （SBP）, diastolic blood pressure （DBP）, pulse pressure （PP） were measured. Ascending aortic systolic diameter, diastolic diameter were detected by ultrasonic technology. Aortic strain（ AS）, aortic stiffness （13） and aortic distensibility （AD） were calculated. Left ventricular basal peak rotation（PBR） and apical peak rotation（PAR） were detected by speckle tracking imaging（ STI）, and the left ventricular peak twist （Ptw） was calculateby. Results The 13, PP and Ptw in E H group were 3.99±0. 47, （74. 2±10. 4）mmHg and （21.73±2. 30）° respectively, in the control group were 2. 75 ± 0. 27, （ 45.9± 5.1 ） mmHg and （ 14. 04± 2. 90 ） ° respectively, and the differences were significant（P=0. 000）. AS and AD in Eh group were 0. 034±0. 012, 1.00±0.47 respectively, in the control group were 0. 106± 0. 028,4. 69± 1.37 respectively, and the differences were significant （ P = 0. 000 ）. Pearson correlation analysis showed there were opsitive correlation between β with PBR, PAR and Ptw （correlation coefficient= 0. 361,0. 719,0. 730; P〈0. 01 or P〈0. 05）, and negative correlation between AD with PBR, PAR and Ptw（ correlation coefficient=-0. 279,-0. 625,-0. 610; P〈0. 01 or P〈0. 05）. Conclusion β,PP and Ptw are high, while AS, AD are poor in patient with EH, and there are associations between β, AD with PBR, PAR and Ptw.