摘要
目的探讨代谢综合征(MS)对老年高血压患者左心室重量和功能的影响。方法选择老年高血压患者513例,根据诊断分为高血压非MS组(266例)和高血压合并MS组(247例)。采用超声心动图测定左心室结构相关参数,计算左心室重量指数(LVMI),并测定左心室舒张早期二尖瓣最大血流速度(E)、舒张晚期二尖瓣最大血流速度(A),计算E/A值和LVEF。结果与高血压非MS组比较,高血压合并MS组LVMI和左心室肥厚率明显升高,E/A明显降低(P<0.05,P<0.01);与单纯高血压比较,合并2项组分和合并3项组分患者左心室肥厚率明显增加(17.1%υs 30.9%υs 37.5%,P<0.05);分别以LVMI、E/A为因变量进行多元线性逐步回归分析,以MS及其他因变量相关因素为自变量,MS与LVMI相关(R^2=0.306,P<0.05);以MS各个组分及其他因变量相关因素为自变量时,收缩压、体重指数、空腹胰岛素与LVMI相关(R^2=0.419,P<0.05),收缩压、体重指数与E/A相关(R^2=0.303,P<0.05)。结论 MS与老年高血压患者的左心室重量增加有关,合并MS者左心室舒张功能受损。
Objective To investigate the influence of metabolic syndrome（MS） on left ventricular mass and function in elderly hypertensive patients. Methods The study was performed in 513 es- sential hypertensive patients. The patients were divided into 2 groups：hypertension without MS （n=266） and hypertension with MS（n=247）. Doppler echocardiography was used to measure the parameters of left ventricular structure,and left ventricular mass index（LVMI） was calculated. The peak of the early diastolic velocity（E） ,the late diastolic wave（A） ,E/A ratio and LVEF were also measured. Results Hypertensive patients with MS displayed significantly higher LVMI, prevalence of left ventricular hypertrophy and lower E/A ratio than those without MS（P〈0.05, P〈0.01）. Compared with hypertensive patients,the hypertensive patients combined with 2 or 3 individual components of MS had significantly higher prevalence of left ventricular hypertrophy （17.1% vs 30.9% vs 37.5% ,P〈0.05）. Multiple linear stepwise regression models were used to test the independent risk factors for LVMI and E/A. When using MS and other related factors as independent variables, MS correlated with LVMI（R2=0. 306, P〈0.05）. When using MS individ- ual components and other dependent variables-related factors as independent variables, systolic blood pressure（SBP）, body mass index（BMI） and fast insulin were significantly correlated with LVMI（R2 =0. 419,P〈0.05） ; SBP and BMI significantly correlated with E/A（Rz = 0. 303, P〈0.05）. Conclusion The MS is associated with LVMI in elderly hypertensive patients,the patients with MS showed early impairment of diastolic function.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2012年第2期142-145,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
关键词
肥胖症
高血糖症
血脂异常
高血压
肥大
左心室
心室功能
左
血流速度
obesity
hyperglycemia
dyslipidemias
hypertension
hypertrophy, left ventricular
ventricular function,left
blood flow velocity
