原发性高血压病不同证型与左室舒张功能不全的关系

The Relationship Between Various Syndromes of Essential Hypertension and Left Ventricular Diastolic Insuffiociency

目的:观察原发性高血压病不同证型与左室舒张功能不全的关系。方法:选择原发性高血压病120例按中医证型分成4组,并以30例健康者为对照,用超声心动图测定左室舒张功能参数。结果:高血压病各组与健康对照组比较,左室重量差异有显著性意义,组间比较差异无显著性意义;高血压病各组与健康对照组比较,舒张早期与舒张晚期峰值流速的比值(E/A),以及舒张早期流速的减速度(EDC)差异有显著性意义;阴虚阳亢、阴阳两虚组与肝火亢盛、痰湿壅盛组比较,E/A、EDC差异有显著性意义;阴阳两虚组与阴虚阳亢组比较,肝火亢盛组与痰湿壅盛组比较,E/A、EDC值差异无显著性意义。结论:除左室肥厚外,中医证型与左室舒张功能异常存在相关性;高血压病患者实证与虚证均已影响心功能,而虚证患者正气亏损,左心舒张功能不全更为显著,这种客观可检测性有可能为中医辨证分型提供参考依据。

Objective:To observe the relationship between various syndromes essential hypertension(EH)and left venticular diastolic insufficiency.Methods:120 cases of EH were allocated to 4 groups according to syndrome differentiation of TCM,and 30 cases of normal subjects served as control.The parameter of left ventricular diastolic function was determined by ultrasonic electrocardiograph.Results:The left ventricular weight was significant different between hypertensive groups and control group,but no significant difference among groups.The peak flow rate ratio(E/A)in early and late of diastolic phase and the flow rate deceleration in early diastolic phase(EDC)also showed significant differences.E/A and EDC were significantly different in yin deficiency with yang hyperactivity and deficiency of both yin and yang syndromes as compared with hyperactivity of liverfire and domination of phlegm-damp syndrome,but there was no significant difference between deficiency of both yin and yang and yin deficiency with yang hyperactivity syndromes as well as hyperactivity of liver-fire and domination of phlegm-damp.Conclusion:Other than left ventricular hypertrophy,the syndrome patterns of TCM is correlated with disorder of left ventricular diastolic function.It is proved that excess and deficiency syndromes of hypertension affects the cardiac function,eapecially in deficiency syndrome with insufficiency of healthy qi,the left ventricular diastolic insufficiency will be more prominent.This objective detectable measure supplies referential evidence for TCM syndrome differentiation.