腹型肥胖及代谢紊乱对高血压病人左室质量指数的影响

Impact of Abdominal Obesity and Metabolic Risk Factors on the Left Ventricular Mass Index in Patients with Essential Hypertension

目的探讨腹型肥胖及代谢紊乱对原发性高血压病人左室质量指数的影响。方法选择2011年1月—2013年12月于本院心血管内科门诊就诊的病人532例,男245例,女287例。分为对照组、单纯高血压组、高血压合并腹型肥胖组和高血压合并代谢综合征组。比较各组病人的基本资料并行常规多普勒超声心动图,测量记录左室结构参数,并比较各组间左室质量指数,及左室肥厚的发生率。结果单纯高血压组左室质量指数、左室肥厚发生率高于对照组(P<0.01),高血压合并腹型肥胖组明显高于对照组及单纯高血压组(P<0.01),高血压合并代谢综合征组高于高血压合并腹型肥胖组(P<0.05)。Spearman相关性分析:左室质量指数与收缩压呈正相关(r=0.784,P<0.01),与腰围呈正相关(r=0.562,P<0.05),与代谢综合征呈正相关(r=0.742,P<0.01)。结论高血压合并腹型肥胖及代谢综合征时,其左室质量指数会明显升高,提示除血压外,腹型肥胖、代谢紊乱、代谢综合征亦会对左心室肥厚产生较大的影响。

Objective To investigate the impact of abdominal obesity and metabolic risk factors of metabolic syndrome on left ventricu-lar mass index in patients with essential hypertension.Methods The clinical date of 532 patients （male 245,female 287）used in this study was derived from the Longfu study cohort in the cardiovascular internal medicine outpatient clinic In January 2011 to December 2013.They were divided into control group,pure hypertension group and hypertension combined abdominal obesity and hypertension combined metabolic syndrome group.Baseline anthropometric and laboratory features were obtained by physical examination.By ech-ocardiography Doppler image,left ventricular structure parameters,and the left ventricular mass index between groups were ana-lyzed.we assayed the relevant data for statistical analysis at last.Results The levels of left ventricular mass index and left ventricular hypertrophy prevalence rates were higher in pure hypertension group than those in control group（P〈0.01）.The date were statisti-cal y significant.They were higher in abdominal obesity with EH group than in pure hypertension group and the control group（P〈0.01）. Merging metabolic syndrome group was higher than hypertension combined abdominal obesity group（P〈0.05）.Spearman correlation a-nalysis showed that a positive correlation between systolic blood pressure and left ventricular mass index（r=0.784,P〈0.01）,and waist circ-umference was positively correlated（r= 0.562,P〈 0.05）,and the metabolic syndrome was also positively correlated（r=0.742,P〈0.01）.Conclusion Hypertension with abdominal obesity and metabolic syndrome,the left ventricular mass index significantly increa-ses.In addition to the level of blood pressure,waist circumference and metabolic risk factors plays a more important role in the devel-opment of hypertensive left ventricular hypertrophy.