老年高血压患者颈动脉硬化与左室舒张功能的关系

Association between left ventricular diastolic function and carotid atherosclerosis in the elderly patients with hypertension

目的探讨老年高血压患者颈动脉硬化和左室舒张功能的关系。方法分别检测、计算老年高血压组(40例)与对照组(40例)的心功能和颈动脉血管参数,并对所测得的各组数据进行统计分析。结果老年高血压组颈总动脉(CCA)、颈内动脉(ICA)、颈总动脉分叉处的内膜-中层厚度(BIMT)、阻力指数(RI)及斑块阳性检出率均明显高于对照组(P<0.01)。老年高血压组左房内径(LAd)、室间隔厚度(IVSd)、左室后壁厚度(LVPWd)及二尖瓣口舒张早期血流速度峰值(E峰)与左心室后壁二尖瓣环舒张早期速度峰值(e峰)比值(E/e)均较对照组增大(P<0.05)。BIMT与LAd及E/e成正相关。结论高血压可引起老年患者左室舒张功能降低,左房增大;对颈动脉的影响多以动脉粥样硬化斑块形成为主要特点。颈动脉粥样硬化程度与老年高血压患者的左室舒张功能有关。

Objective To investigate the relationship of left ventricular diastolic function with carotid atherosclerosis in the elderly patients with hypertension.Methods A total of 40 elderly patients with hypertension and 40 controls were enrolled,and the parameters of heart function and carotid artery were measured and analyzed.Results Compared with the control group,the intima-media thickness(IMT) of common carotid artery(CCA),internal carotid artery(ICA) and ca-rotid bifurcation,resistance index(RI) and the detection rate of total plaques in hypertension group increased significantly(P <0.01).Compared with the control group,the left atrial diameter(LAd),interventricular septum thickness(IVSd),left ventricular posterior wall thickness(LVPWd) and the ratio of peak early-diastolic mitral orifice flow velocity and peak early-diastolic mitral annular velocity in left ventricular posterior wall(E/e) were higher in the hypertension group(P < 0.01).There were positive correlation between IMT and LAd,E/e.Conclusions Hypertension can cause the decrease of left ventricular diastolic function in the elderly patients with hypertension.Atherosclerosis plaques are the frequent abnor-mal finding in carotid arteries in the elderly patients with hypertension.There is a positive correlation between carotid ather-osclerosis degree and left ventricular function.