高血压患者主动脉根部或升主动脉内径扩张的临床意义

The significance of dilatation of aortic root and aortic artery in essential hypertension patients

目的研究高血压患者主动脉根部或升主动脉内径扩张的临床意义。方法选取2007年12月至2009年8月经我院超声心动图检查确诊的主动脉根部或升主动脉内径扩张的高血压患者174例,以性别、年龄匹配的主动脉根部及升主动脉内径正常的高血压患者70例为对照,分析主动脉根部或升主动脉内径扩张的高血压患者的临床特征。结果主动脉根部或升主动脉内径扩张组中,合并吸烟[47.3%(82/174)比31.4%(22/70)]、血脂异常[52.7%(91/174)比44.3%(31/70)]、动脉粥样硬化性疾病[54.1%(94/174)比42.9%(30/70)]的比例高于非扩张组(均为P<0.05);在主动脉根部内径扩张组,室间隔厚度[(11.6±5.5)mm比(10.7±2.7)mm,P=0.02]、左房大小[(39.1±5.9)mm比(37.8±6.5)mm,P=0.03]、E/Em(9.3±3.8比7.8±2.9,P=0.03)均较高;E峰速度[(72±14)cm/s比(75±16)cm/s,P<0.01]、Em[(7.7±2.7)cm/s比(9.4±2.6)cm/s,P<0.01]及E/A(0.86±0.29比1.03±0.30,P=0.02)较低。逐步Logistic回归分析显示,年龄、室间隔厚度、E/A和E/Em是主动脉根部或升主动脉内径扩张的独立影响因素。结论主动脉根部或升主动脉内径扩张的高血压患者常有多种心血管危险因素的聚集,并伴有心脏结构和功能的异常。

Objective To evaluate the significance of dilatation of aortic root and aortic artery in primary hypertension patients. Methods A total of 174 hypertensive subjects with aortic root and aortic artery dilation（echocardiography confirmed）were enrolled in this study from December 2007 to August 2009, 70 patients with normal aortic root and aortic artery diameters were enrolled as control group with age and sex matched.Clinical characteristics and echocardiographic parameters were compared between two groups.Results Compared with the control group,the prevalence of smoking[47.3%（82/174）vs.31.4%（22/70）],dyslipidemia [52.7%（91/174）vs.44.3%（31/70））and atherosclerosis[54.1%（94/174）vs. 42.9%（30/70）]were higher in aortic root and aortic artery dilation group（all P〈0.05）.The diameter of left atrial [（39.1 ±5.9）mm vs.（37.8 ±6.5）mm],inter-ventricular septum（IVS）[（11.6 ±5.5）mm vs. （10.7 ±2.7）mm]and E/Em[（9.3 ±3.8）vs.（7.8 ±2.9）was statistically higher in aortic root and aortic artery dilation group than control group（all P〈0.05）;while E peak velocity[（72 ±14）cm/s vs.（75 ±16）cm/s）,Em[（7.7 ±2.7） cm/s vs.（9.4 ±2.6） cm/s） and E/A[（0.86 ±0.29） vs.（1.03 ±0.30）] was significantly lower in aortic root and aortic atery dilation group than those in control group （ all P〈0.05 ） . Logistic regression analysis demonstrated that age, IVS, E/A and E/Em were the independent factors for aortic root and aortic artery dilatation.Conclusions Hypertensive patients with aortic root and aortic artey dilatation often have multiple cardiovascular risk factors and abnormalities of cardiac structure and function.