超声心动图评价单纯主动吸烟及吸烟合并高血压者的左心室功能

The evaluation of left ventricular function about smoking and smoking complicating with hypertension

目的:通过运用超声心动图方法检测单纯主动吸烟者和吸烟合并高血压者的左心功能,探讨二者对左心室功能的影响、以及两组之间收缩及舒张功能的差异。方法:30名正常非吸烟者,31例单纯主动吸烟患者,23例吸烟合并高血压患者,分别采用二维超声、脉冲多普勒和多普勒组织成像技术对3组的左室舒张、收缩功能各项指标进行检测并对比分析,指标主要有左心房收缩末期最大径(LA)、二尖瓣口舒张早期血流速度(E)、舒张晚期血流速度(A)、E/A、二尖瓣外环舒张早期运动速度(Em)、舒张晚期运动速度(Am)、Em/Am、计算E/Em,等容舒张期(IVRT),E峰减速时间(EDT),肺静脉S峰值/D峰值(Vs/Vd),AR波持续时间(ARD)、左室缩短率(FS),左室射血分数(EF),左室肌重量指数(LVMI),并分析年龄、心率、收缩压、舒张压、脉压差、吸烟年数、吸烟指数对各组间有差异指标的影响。结果:(1)吸烟合并高血压组ARD、LA、A、E/Em、EDT、LVMI高于正常组(P<0.05),单纯主动吸烟组ARD高于正常组(P<0.05),吸烟合并高血压组ARD高于单纯主动吸烟组(P<0.05);Em吸烟合并高血压组低于单纯主动吸烟组和正常组(P<0.05);E、Am、Vs/Vd、FS、EF 3组间比较无统计学意义(P>0.05)。(2)多元回归分析表明吸烟合并高血压组收缩压对LA有影响,心率对ARD有影响,吸烟年数对A有影响,脉压差对Em有影响。(3)吸烟合并高血压组收缩压、舒张压、脉压差高于单纯主动吸烟组及正常组(P<0.05),单纯主动吸烟组收缩压、舒张压、脉压差与正常组比较统计学无差异(P>0.05)。结论:吸烟可引起个别左室舒张功能指标降低,高血压加重吸烟对心脏舒张功能的影响。

ObjectiveThrough the use of echocardiography, we detect left ventricular function of smoking and smoking complieatingwith hypertension, and the impact on left ventricular function of both, and the difference between systolic and diastolic function.Methods ： 30 cases of non sm okers,31 cases simple smoking people, 23 cases of smoking people with hypertension, then apply two-dimensionalultrasound, pulse Doppler and tissue Doppler to detect and analyze the left ventricular diastolic, systolic function index of thethree groups, such as end systolic left atrium diameter （L A ） , early diastolic mitral flow velocity （E ） , late diastolic flow velocity （ A ） ,E /A , early diastolic mitral annular velocity of the （E m ） , late diastole （A m ） , Em /Am , E /Em , isovolumic relaxation time （ IVRT ） , Edeceleration time （ED T） , pulmonary vein S peak/D peak （V s/V d） ,AR wave duration （A R D ） , left ventricular shortening （F S ） , leftventricular ejection fraction （ EF ） , left ventricular muscle mass index （LV M I） , and analysis the influence of age, heart rate, systolicblood pressure , diastolic blood pressure, pulse pressure, the year of smoking and smoking index on the different indicators betweengroups. Results ： Smoking with hypertension group LVMI, LA , A , E /E m , EDT, ARD was higher than the normal group （ P 〈 0. 05） , simplesmoking group ARD was higher than normal group （ P 〈 0. 05 ） , smoking with hypertension group ARD was higher than simplysmoking group （ P 〈 0. 05 ） . Em in smoking with hypertension group was lower than simple smoking group and normal group （ P 〈0. 0 5 ）. E , A m , Vs / V d, F S , EF among the three groups showed no significant difference （ P 〉 0. 05 ）. Multiple regression showed that smoking combined with hypertension systolic blood pressure affected the LA ,heart rate affected A RD ,the smoking years affected the A ,pulse pressure affected the Em. Smoking combined with hypertension systolic blood pressure, diastolic blood pressure, pulse pressurehigher than that in simple smoking group and normal group （P 〈 0. 05 ） . There was no difference between simple smoking group and thenormal group of systolic blood pressure , diastolic blood pressure and pulse pressure （ P 〉 0. 05 ） . Conclusion ： Smoking reduced someleft ventricular diastolic function index, hypertension increase the influence of smoking on diastolic function.