摘要
目的:心脏病患者体质肥胖可增加心脏负荷,观察单纯中、重度肥胖对人体左心功能指标的影响。方法:2001-06/2004-06在肇庆市第一人民医院门诊就诊确诊为单纯性中、重度肥胖患者39例(单纯性肥胖组,体质量指数≥30kg/m2)。男21例,女16例。均自愿参加。排除合并有慢性心肺疾病和其他严重躯体性疾病者。选择同期在本院进行体检的健康非肥胖自愿者39人为对照组(体质量指数<25kg/m2)。两组均在静息条件下进行多普勒超声心动图检查,测定两组对象左室舒张功能指标(左室舒张早、晚期峰值流速及两者比值,左室等容舒张时间,左房射血前期时间,左房射血时间)和左室收缩功能指标(左室舒张末内径、左室收缩末内径、心脏指数、左室短轴缩短率、周径纤维缩短速度、左室射血分数)。结果:按意向处理分析,进入结果分析的中重度肥胖患者39例和体质量正常人39人。①左室舒张功能指标:肥胖组左室舒张早期峰值流速、左房射血前期时间明显低于和短于对照组[(69.60±14.37)mm/s,(85.34±17.75)ms;(72.14±20.52)mm/s,(88.46±18.23)ms,P<0.05]。左室舒张晚期峰值流速,左室舒张早、晚期峰值流速比值,左房射血时间,左室等容舒张时间明显高于和长于对照组[(56.62±11.36)mm/s,0.87±0.01,(121.28±19.37)ms,(89.27±16.82)ms;(53.36±13.44)mm/s,0.85±0.02,(117.42±26.50)ms,(86.97±17.42)ms,P<0.05]。②左室收缩功能指标:肥胖组除左室收缩末期内径、左室舒张末期内径、心脏指数明显高于对照组(P<0.05)。左室短轴缩短率、周径纤维缩短速度、左室射血分数差异不明显。结论:单纯肥胖是亚临床型左室功能障碍的一个独立危险因素。单纯中、重度肥胖可引发人体左心收缩和舒张功能不同程度的障碍。
AIM: Obesity in patients with heart disease can increase their cardiac load. The paper observes the influence of simple moderate and severe obesity on the indexes of left ventricular function. METHODS: Thirty-seven patients (21 males and 16 females) with simple moderate and severe obesity (simple obesity group, body mass index ≥ 30 kg/m2), who were diagnosed in Zhaoqing First People's Hospital between June 2001 and June 2004, took part in this study voluntarily; Those accompanied by chronic cardiapumonary disease and other severe somatic diseases were excluded; Another 37 healthy non-obese volunteers, who were the physical examinees in this hospital at the same period, were selected as controls (control group, body mass index < 25 kg/m2). The patients in both groups received examination of Doppler echocardiography at rest; The indexes of left ventricular diastolic function (left ventricular diastolic peak flow rates at early and late periods and their ratio, left ventricular isovolumetric relaxation time, left atrial pre-ejection period, left atrial ejection period) and indexes of left ventricular systolic function (left ventricular end-diastolic diameter, left ventricular end systolic diameter, cardiac index, short axis fractional shortening, shortening velocity of diameter fiber and left ventricular ejection fraction). RESULTS: According to intention-to-treat analysis, all the 39 patients with moderate and severe obesity and 39 subjects with normal body mass were involved in the analysis of results.①Indexes of left ventricular diastolic function: left ventricular diastolic peak flow rate at early period and left atrial pre-ejection period in the obesity group were obviously lower and shorter than those in the control group [(69.60±14.37) mm/s, (85.34±17.75) ms; (72.14±20.52) mm/s, (88.46 ±18.23) ms, P < 0.05]; The left ventricular diastolic peak flow rate at late period, the ratio of left ventricular diastolic peak flow rate at early period to that at late period, left atrial ejection period and left ventricular isovolumetric relaxation time were obviously higher or longer in the obesity group than in the control group [(56.62±11.36) mm/s, 0.87±0.01, (121.28±19.37) ms, (89.27±16.82)ms; (53.36±13.44) mm/s, 0.85±0.02, (117.42±26.50) ms, (86.97±17.42) ms, P < 0.05].②Indexes of left ventricular systolic function: The left ventricular end-diastolic diameter, left ventricular end systolic diameter and cardiac index were obviously higher in the obesity group than in the control group (P < 0.05), and there were no obvious differences in the short axis fractional shortening, shortening velocity of diameter fiber and left ventricular ejection fraction between the two groups. CONCLUSION: Simple obesity is an independent risk factor for sub-clinical left ventricular dysfunction. Simple moderate and severe obesity can lead to left ventricular systolic and diastolic dysfunctions to different degree.
出处
《中国临床康复》
CSCD
北大核心
2005年第23期26-27,共2页
Chinese Journal of Clinical Rehabilitation
