原发性高血压患者脉压与左心室肥厚及射血分数保留的心衰的相关性

Correlation of Pulse Pressure with Left Ventricular Hypertrophy and Heart Failure with Preserved Ejection Fraction in Patients with Essential Hypertension

目的研究原发性高血压患者脉压与左心室肥厚及射血分数保留的心衰的相关性。方法选取新乡医学院第一附属医院2017年10月~2019年10月就诊的原发性高血压患者103例,依据射血分数保留心衰的诊断标准分为心衰组和单纯高血压组,另将心衰组根据NYHA分级分为Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级,比较两组一般资料、实验室指标、心功能各指标,并分析射血分数保留心衰患者的脉压与心功能各指标相关性分析及心衰组不同NYHA分级患者的脉压。结果103例患者中心衰组49例,高血压组54例;心衰组与高血压组一般资料与实验室指标比较,差异无统计学意义(P>0.05);心衰组脉压、NT-proBNP、LVEDd、LAD、IVST、LVPWT、LVMI均高于高血压组,LVEF、E/A均低于高血压组,差异有统计学意义(P<0.05);脉压与BNP、LVMI、NYHA分级间均呈正相关关系(r=0.542、0.415、0.428,P<0.05),脉压与E/A间呈负相关关系(r=-0.415,P<0.05);不同NYHA分级患者脉压比较,差异有统计学意义(P<0.05),且随心衰程度加重,脉压值增大。结论脉压与NT-proBNP、LVMI、NYHA分级、E/A密切相关,且随心衰程度的加重,脉压值增大。

Objective To study the correlation between pulse pressure and left ventricular hypertrophy and heart failure with preserved ejection fraction in patients with essential hypertension.Methods A total of 103 patients with primary hypertension who were admitted to the First Affiliated Hospital of Xinxiang Medical University from October 2017 to October 2019 were selected and divided into the heart failure group and the simple hypertension group based on the diagnostic criteria of heart failure preserved by ejection fraction.In addition,the heart failure group was divided intoⅠ,Ⅱ,Ⅲ,andⅣaccording to NYHA classification.The general data,laboratory indexes,and various indexes of heart function were compared between the two groups,and the pulse pressure and pulse pressure of patients with heart failure preserved by ejection fraction were analyzed.Correlation analysis of various indexes of heart function and pulse pressure of patients with different NYHA grades in heart failure group.Results There were 49 cases in the central failure group of 103 patients and 54 cases in the hypertension group.There was no significant difference in general data and laboratory indicators between the heart failure group and the hypertension group(P>0.05);the pulse pressure and NT-proBNP in the heart failure group,LVEDd,LAD,IVST,LVPWT,LVMI are all higher than the hypertension group,LVEF,E/A are lower than the hypertension group,the difference was statistically significant(P<0.05);between pulse pressure and BNP,LVMI,NYHA classification All showed a positive correlation(r=0.542,0.415,0.428,P<0.05),and there was a negative correlation between pulse pressure and E/A(r=-0.415,P<0.05);Compared with patients with different NYHA grades,the difference in pulse pressure was statistically significant(P<0.05),and the pulse pressure value increased with the severity of heart failure.Conclusion Pulse pressure is closely related to NT-proBNP,LVMI,NYHA grade,and E/A,and the pulse pressure value increases with the severity of heart failure.