高血压病患者左心房射血力改变及其影响因素分析

Variation of left atrial ejection force and its determinants in patients with primary hypertension

目的 评价高血压病患者左心房射血力 (leftatrialejectionforce ,LAEF)及左心房射血力指数(leftatrialejectionforceindex ,LAEFI)改变 ,探讨导致其改变的因素。方法 应用二维超声心动图及多普勒技术 ,比较 2 8例正常人与 5 4例高血压病患者LAEFI;以正常人LAEFI均数 + 2倍标准差为正常上限值 ,将高血压患者分组后行组间比较 ;应用逐步回归方法探讨高血压病患者LAEFI改变的主要影响因素。结果 ①高血压病患者组LAEFI较正常组显著增大 [(0 .182 5± 0 .0 793 )N/m2 对 (0 .0 911± 0 .0 3 87)N/m2 ,P <0 .0 0 1] ;②以LAEFI为因变量 ,以年龄 (AGE)、收缩压、舒张压、总外周阻力、心率、左心室重量指数 (LVMI)、左心房开始收缩时容积指数 (LAPVI)等为自变量 ,经逐步回归分析发现只有LAPVI、AGE及LVMI依次进入回归方程 ,其回归方程为 :Y =-0 .14 2 1+ 0 .0 0 5 1LAPVI + 0 .0 0 2 8AGE + 0 .0 0 0 8LVMI。结论 ①高血压病患者LAEFI显著高于正常组 ;②LAPVI、AGE及LVMI为导致高血压病患者LAEFI增大的主要因素。

Objective To evaluate the variation of left atrial ejection force index (LAEFI) and its determinants in patients with primary hypertension. Methods Using two-dimensional and Doppler echocardiography, LAEFI was measured in 28 normal subjects (control group) and 54 patients with primary hypertension (hypertensive group). Taking the mean + 2SD of LAEFI of the control group as the upper cut-off value, the hypertensive group was divided into two subgroups: group I of LAEFI within the normal range and group II above that. Related clinical variables and echo parameters were compared between the two groups, and stepwise regression was made to determine the influencing factors of LAEFI variation in hypertensive group. Results (1) LAEFI of hypertensive group was larger than that of control group. (2) Multivariate regression demonstrated that LAPVI, AGE and LVMI entered the regression equation.Conclusions (1) LAEFI increased in patients with hypertension, indicating that left atrial systolic function is strengthened for compensation. (2) LAPVI, AGE and LVMI are the most important determinants of LAEFI variation in patients with hypertension.