初发轻度高血压患者内皮功能与左心室肥厚的相关性研究

Correlation between endothelial function and left ventricular hypertrophy in patients with untreated mild hypertension

目的比较初发轻度高血压合并左心室肥厚(left ventricular hypertrophy,LVH)患者的内皮功能变化,探讨内皮功能和左心室肥厚的相关性。方法回顾性分析2016年4月至2016年10月就诊于首都医科大学宣武医院心脏内科的初发轻度原发性高血压患者174例,根据超声心动图结果分为高血压合并左心室肥厚组和高血压不合并左心室肥厚组,比较2组患者的临床特征、内皮功能及超声心动图参数。应用Logistic回归分析左心室肥厚与内皮功能的相关性。结果与高血压不合并LVH组比较,高血压合并左心室肥厚组的反应性充血指数更低,内皮功能障碍(反应性充血指数<1.67)的比例更高(P<0.05)。多因素Logistic回归分析显示:反应性充血指数与左心室肥厚具有相关性(OR=0.230,P=0.001)。结论初发轻度高血压患者的内皮功能与左心室肥厚关系密切,反应性充血指数降低是初发轻度高血压患者合并左心室肥厚的重要危险因素。

Objective To compare the endothelial function in patients with untreated mild hypertension with left ventricular hypertrophy(LVH),and to explore the correlation between endothelial function and left ventricular hypertrophy.Methods A retrospective analysis of 174 patients with untreated mild essential hypertension who were admitted to the Department of Cardiology,Xuanwu Hospital,Capital Medical University from April 2016 to October 2016 was performed.According to the results of echocardiography,the patients were divided into the hypertension with LVH group and the hypertension without LVH group,and the clinical characteristics,endothelial function and echocardiographic parameters were compared with each other.Logistic regression was used to analyze the correlation between left ventricular hypertrophy and endothelial function.Results Compared with hypertension without left ventricular hypertrophy group,reactive hyperemia index was lower and the proportion of endothelial dysfunction(reactive hyperemia index<1.67)was higher in patients with hypertension and left ventricular hypertrophy(P<0.05).Multivariate Logistic regression analysis showed that the reaction hyperemia index was still associated with left ventricular hypertrophy(OR=0.230,P=0.001).Conclusion The endothelial function of patients with untreated mild essential hypertension is closely related to left ventricular hypertrophy.The decrease of reactive hyperemia index is an important risk factor for left ventricular hypertrophy in patients with untreated mild hypertension.