高血压病左房构型改变的临床研究

Clinical study of left atrial geometric patterns in patients with hypertension

目的:探讨高血压病左房构型的改变及其相关性。方法:对照组20例,高血压病左室心肌重量指数(LVMI)正常组32例,高血压病左室肥厚组16例,采用超声心动图技术,测量左房内径(LAD)、左房内径指数(LADI)。结果:高血压病LVMI正常组与左室肥厚组LAD均较对照组增高,而LADI在高血压病左室肥厚组较对照组增大,高血压病LVMI正常组则较对照组差异无统计学意义;LAD与以下指标的相关性依次为:LVMI(r=0.61、P<0.001)、脉压(r=0.32,P<0.01)、体重指数(r=0.31,P<0.05)、年龄(r=0.26,P<0.05)、体表面积(r=0.25,P<0.05);女性组LADI大于男性组(P<0.05);与舒张压、收缩压及平均动脉压均无显著相关。结论:高血压病患者左房构型发生了显著改变,左室重构发生在左房构型改变之前;左房内径与左室心肌重量指数、脉压、体重指数、年龄及体表面积呈正相关,与性别有关,与收缩压、舒张压及平均动脉压无关。

Objective:To evaluate the left atrial geometric patterns and its correlations in pa-tients with hypertension by ultrasonographic technique.Methods:Forty-eight hypertensive patients and20control subjects were studied.Patients with hypertension were divided into two groups by left ven-tricular mass index(LVMI),normal LVMI group and left ventricular hypertrophy(LVH)group.Left a-trial dimension(LAD)and left atrial dimension index(LADI)were measured.Results:Compared with control subjects,LAD was significantly increased in patients with normal LVMI group and LVH group.However,LADI was only higher in patients with LVH group than that in control subjects.There was no difference between patients with normal LVMI group and control subjects about LADI.The indices positively correlating LAD were:LVMI (r=0.61,P<0.001),pulse pressure(r=0.32,P<0.01),body mass in-dex(r=0.31,P<0.05),age(r=0.16,P<0.05),body surface area(r=0.25,P<0.05),LADI was larger in female group than in male group(P<0.05).Conclu sions:In patients with essential hypertension,left ventricular remolding precedes left atrial enlargement.Left atrial dimension is positively correlated with LVMI,pulse pressure,body mass index,age and body surface area,and is related to sex.Correlations of left atrial dimension with SBP,DBP and MAP are not found.