高血压患者主动脉扩张性改变与左心室向心性重构关系探讨

Correlation between aortic distensibility variation and left ventricular concentric remodeling in patients with primary hypertension

目的 探讨高血压患者主动脉扩张性改变与左心室向心性重构的关系。方法 应用二维及多普勒超声心动图技术对比观察 3 2例高血压患者和 2 3例健康志愿者主动脉扩张性 (aorticdistensibility ,AD)与年龄、血压以及左心室向心性重构参数—相对室壁厚度 (relativewallthickness ,RWT)的关系 ;以正常对照组AD平均值-1.64 5倍标准差作为正常低限值将高血压患者分组并比较两组间各参数的差别 ;应用多元逐步回归方法分析高血压病患者AD与RWT等参数的关系。结果 高血压病组AD较正常对照组显著减低 ;高血压患者AD减低组的RWT、年龄、收缩压等参数与AD正常组相比 ,差异有显著性意义 ;单因素直线回归分析表明高血压病组AD与RWT、年龄、收缩压呈显著负相关 ,多元逐步回归分析表明RWT、年龄、收缩压依次进入方程。结论 高血压患者主动脉扩张性较正常人明显减低 ,其程度与左心室相对室壁厚度、年龄及收缩压密切相关。

Objective To evaluate the variation of aortic distensibility and its relation with left ventricular concentric remodeling in patients with primary hypertension.Methods Using two-dimensional and Doppler echocardiography,aortic distensibility (AD) and relative wall thickness (RWT),a parameter of left ventricular concentric remodeling were measured in 23 normal subjects (control group) and 32 patients with primary hypertension (hypertensive group).Taking the mean- 1.645 s of control group as the normal cut off value of AD,the hypertensive group was divided into two subgroups: group I with AD value lower than normal and group II within the normal range.Related clinical variables and echo parameters were compared between the two groups and stepwise regression was made to determine the relationship between AD and RWT.Results AD of hypertensive group was lower than that of control group; Univariate analysis showed that AD was significantly related to RWT,age and systolic blood pressure in hypertensive group; Multivariate regression demonstrated that RWT,age and systolic blood pressure entered the regression equation.Conclusions Aortic distensibility decreased in patients with hypertension and its reduction showed close relations with concentric remodeling of left ventricle,aging and increased systolic blood pressure.