高血压伴左心室肥厚患者心外膜脂肪组织增厚与微量白蛋白尿的关系

Relationship between EAT thickening and microalbuminuria in hypertension patients with left ventricular hypertrophy

目的探讨左心室肥厚高血压患者心外膜脂肪组织(EAT)增厚与微量白蛋白尿的关系。方法选择高血压患者160例,根据超声心动图检查分为左心室肥厚组(肥厚组)和无左心室肥厚组(无肥厚组),每组80例,以同期门诊健康体检者80例为对照组。采用经胸超声心动图检查EAT厚度。采用Pearson相关性分析,用logistic回归分析微量白蛋白尿发生的危险因素,采用ROC曲线分析。结果 3组收缩压、舒张压、微量白蛋白尿、左心房内径(LAD),舒张末期室间隔厚度(IVST)、左心室后壁舒张末期厚度(LVPWT)、左心室质量指数(LVMI)、EAT厚度比较,差异有统计学意义(P<0.01)。肥厚组收缩压、舒张压、微量白蛋白尿比例、LAD、IVST、LVPWT、LVMI、EAT厚度显著高于对照组和无肥厚组(P<0.05)。肥厚组微量白蛋白尿与年龄(r=0.253,P=0.004),舒张压(r=0.184,P=0.030),LVEF(r=0.278,P=0.000),LVMI(r=0.365,P=0.000),EAT厚度(r=0.506,P=0.000)呈显著正相关。LVMI,EAT厚度是左心室肥厚高血压患者微量白蛋白尿的独立危险因素。EAT厚度预测微量白蛋白尿的最佳临界值为5.8 mm, ROC曲线下面积为0.794(95%CI:0.703~0.892,P<0.01)。结论 EAT厚度与左心室肥厚高血压患者微量白蛋白尿呈显著正相关,且是微量白蛋白尿的重要预测因子。

Objective To study the relationship between EAT thickening and MA in hypertension patients with LVH.Methods One hundred and sixty hypertrension patients were divided into hypertrophy group(n=80) and hypertrophy-free group(n=80) according to their echocardiography with 80 subjects who underwent physical examination served as a control group.Their EAT thickness was measured by transthoracic echocardiography.The relationship between EAT thickening and MA in hypertension patients with LVH was analyzed by Pearson correlation analysis.The risk factors for MA in hypertension patients with LVH were analyzed by logistic regression analysis and ROC curve analysis respectively.Results The SBP,DBP,MA ratio and LVMI were significantly higher, the LAD was significantly longer, the end-diastolic IVST,end-diastolic LVPWT and EAT thickness were significantly thicker in hypertrophy group than in control group and hypertrophy-free group(P<0.05).MA was positively related with age, DBP,LVEF,LVMI and EAT thickness in hypertrophy group(r=0.253,P=0.004;r=0.184,P=0.030;r=0.278,P=0.000;r=0.365,P=0.000;r=0.506,P=0.000).LVMI and EAT thickness were the independent risk factors for MA in hypertension patients with LVH.The optimal cutoff value of EAT thickness for predicting MA in hypertension patients with LVH was 5.8 mm, and the AUC was 0.794(95%CI:0.703-0.892,P<0.01).Conclusion EAT thickness is positively related with MA and is thus an important predictor of MA in hypertension patients with LVH.