高血压患者动态动脉硬化指数与左心室舒张功能的相关性

Correlation of Ambulatory Arterial Stiffness Index with Left Ventricular Diastolic Function in Patients with Essential Hypertension

目的探讨高血压患者动态动脉硬化指数(AASI)与左心室舒张功能的相关性。方法选择安徽医科大学合肥第三临床学院心内科住院,且初次诊断为原发性高血压患者143例,按是否存在左心室舒张功能不全分为两组,并选择血压正常的患者为对照组(60例)。所有患者入院后在服药前均检测血尿酸、空腹血糖、总胆固醇等水平。心脏多普勒超声评价左心室舒张功能。并采用常规24 h动态血压监测数据计算高血压病患者AASI。分析比较三组间患者AASI与左心室舒张功能的相关性。结果三组患者性别、年龄、体质指数、空腹血糖、总胆固醇及高密度脂蛋白比较差异均无统计学意义(P>0.05);左心室舒张功能不全组患者AASI、血尿酸、同型半胱氨酸、高敏C反应蛋白及低密度脂蛋白水平等明显高于左心室舒张功能正常组(P<0.05)。Logistic多因素回归分析表明,AASI是高血压患者左心室舒张功能的影响因素。Pearson相关性分析显示AASI与E/A呈明显负相关(r=-0.697,P<0.05),AASI与E/Ea呈明显正相关(r=0.614,P<0.05)。结论 AASI可能是原发性高血压患者出现左心室舒张功能不全的一个标志。

Aim To investigate the relationship between ambulatory arterial stiffness index（AASI）and left ventricular diastolic function in patients with essential hypertension. Methods 143 patients who had been diagnosed with essential hypertension were divided into two groups,with or without left ventricular diastolic dysfunction group. At the same time 60 patients with normal blood pressure were enrolled into control group. Uric acid（UA）,total cholesterol（TC）,low density lipoprotein（LDL）,high density lipoprotein（HDL）,fasting blood glucose（FBG）,homocysteine（Hcy）and high sensitive C reactive protein（hs-CRP）were measured before treatment. The AASI were detected by 24-hour ambulatory blood pressure monitoring. Left ventricular diastolic function was assessed by pulsed Doppler tissue imaging. Subsequently,the relationship was analysed between AASI and left ventricular diastolic function. Results There were no significant differences in sex,age,body mass index（BMI）,FBG,TC,HDL among three groups（P〈0. 05）. The AASI,UA,Hcy,hs-CRP and LDL were significantly higher in left ventricular diastolic dysfunction patients（P〈0. 05）. The AASI was negatively correlated with E/ A（r=-0. 697,P〈0. 05）and positively correlated with E/ Ea（r= 0. 614,P〈0. 05）. Conclusion AASI might be a marker of diastolic dysfunction in essential hypertension patients.