高血压合并代谢综合征患者血管超负荷指数和左室肥厚相关性.docVIP

高血压合并代谢综合征患者血管超负荷指数和左室肥厚的相关性 　　作者：王亚蓉,黄小云,韦建瑞　　作者单位：暨南大学第四附属医院/广州市红十字会医院 心内科，广东 广州 510220; 2.华南农业大学校医院, 广东 广州 510642 　　【摘要】 目的 研究高血压合并代谢综合征(MS)患者血管超负荷指数(VOI)与左室肥厚的相关性。方法 2007年7月至2009年4月我院门诊及住院的高血压合并MS患者112例，64例未合并MS的高血压患者作为对照组，所有患者都进行血糖、血脂、心脏彩色多普勒检测,计算左心室质量指数(LVMI),并研究VOI与LVMI的相关性。结果 和对照组相比，合并MS高血压患者，其VOI和LVMI较对照组显著增加(P0.05或P0.01)。多元回归分析发现VOI是LVMI独立的危险因子,VOI与 LVMI具有相关性(R2=0.63,P0.01)。结论 代谢综合征各组分协同作用增加了高血压患者左室肥厚，VOI和LVMI密切相关，VOI是介导心脏靶器官损害的独立危险因子。 　　【关键词】 高血压,代谢综合征,血管超负荷指数;左室肥厚 　　Abstract:Objective The study was aimed to evaluate effects of vascular overload index(VOI) on left ventricular (LV) in essential hypertensive patients with metabolic syndrome(MS). Methods Blood glucose levels, blood lipid levels, and heart color Doppler were tested in 112 essential hypertensive patients with MS in our hospital from June, 2007 to April, 2009 and 64 essential hypertensive patients without MS as the control subjects, left ventricular mass indices (LVMIs) were calculated and the correlation between VOI and LVMI was studied. Results Compared with the control group, the VOIs and LVMIs in the essential hypertensives with MS increased significantly with P0.05 and P0.01 respectively. After adjusting the weights of age, gender of patients, blood glucose level, and blood lipid level, it was found in multiple regression analysis that VOI and LVMI were independent risk factors, VOI and LVMI were correlated (R2=0.63, P0.01). Conclusion The synergy of all components of metabolic syndrome resulted in an increase of left ventricular hypertrophy in hypertensive patients with MS, VOI and LVMI were correlated, and VOI was independent risk factor to induce target organ damage. 　　Key words:essential hypertension; metabolic syndrome(MS); vascular overload index(VOI); left ventricular mass index( LVMI) 　　高血压可导致心、脑、肾等多个器官和系统的损害。临床上高血压很少独立存在，常合并多种代谢紊乱，包括肥胖、脂代谢紊乱、糖代谢异常等，1998年WHO把这些代谢紊乱称为代谢综合征(metabolic syndrome，MS)。已有证据表明MS加重高血压患者靶器官损害 [1-3]，高血压合并MS患者较单纯高血压患者靶器官损害的风险更大。Franklin等[2]