原发性高血压患者bapwv与左室舒张功能的相关性分析-correlation between bap wv and left ventricular diastolic function in patients with essential hypertension.docxVIP

摘要目的：动脉硬化使动脉僵硬度增加，从而易导致舒张功能不全。臂-踝脉搏波传导速度（baPWV）是评价动脉硬化的经典指标，可作为评价心功能的一个指标。然而臂-踝脉搏波传导速度与左室舒张功能的关系尚未清楚。故本研究通过探讨两者的关系，确认baPWV是否可作为评估左室舒张功能障碍的早期指标，为更早发现并及早干预左室舒张功能不全提供线索。方法：选择明确诊断为原发性高血压的住院患者100例，空腹抽取外周静脉血液测定相关生化指标。应用超声心动图测定相关参数（二尖瓣舒张早期快速充盈E峰和舒张晚期充盈A峰以及二尖瓣瓣环舒张早期速度e’值和舒张晚期速度a’）以评估左室舒张功能。根据E/e’值是否大于15将患者分为左室舒张功能不全组和左室舒张功能正常组，并运用无创全自动动脉硬化检测仪测定基础baPWV值，评估动脉硬化程度；并进行相关性研究。结果：1.左室舒张功能不全组baPWV显著大于舒张功能正常组，两组差异有统计学意义（P0.05）。2.经直线相关分析证明baPWV与E/e’呈正相关（r=0.388，P=0.000），臂-踝脉搏波传导速度与左室舒张功能呈负相关，即baPWV越快，左室舒张功能越差。3.baPWV与年龄、心率、收缩压、脉压、空腹血糖、室间隔厚度、左室舒张末内径、左室后壁厚度呈正相关（P0.05），年龄、空腹血糖、心率、脉压明显影响baPWV。4.年龄、baPWV、左室舒张末内径、左室后壁厚度是影响左室舒张功能的显著因素。结论：动脉硬化是导致左室舒张功能减退的主要原因，baPWV可作为评估左室舒张功能的一个指标。关键词：原发性高血压；动脉硬化；脉搏波传导速度；多普勒超声；左室舒张功能AbstractObjective:Arteriosclerosisincreasedarterialstiffness,whicheasilycausediastolicdysfunction.Brachial-anklepulsewavevelocity(baPWV)isaclassicindicatorofarteriosclerosisandcanbeusedasanindicatorofcardiacfunction.Today,relationshipbaPWVandleftventriculardiastolicfunctionhasnotyetapparent.Bymeansofresearchingthem,thisstudyinvestigatewhetherbaPWVisanearlyindextoevaluateleftventriculardysfunction,whileitcouldprovidecluesformoreearlierfordetectingandinterveningleftventriculardiastolicdysfunction.Methods:100ofessentialhypertensivepatientswereenrolledandextractedperipheralvenousbloodtodetectrelatedbiochemicalindex.TissueDopplerImaging（TDI）echocardiography,throughthemeasurementofrelevantparameters(E、A、eanda),isusedtoevaluateleftventriculardiastolicfunction.AccordingtoE/e,patientswillbedividedtwogroups:theleftventriculardiastolicdysfunctiongroupandthenormalgroup,andbaPWVisusedtoassessatherosclerosis.Results:1.baPWVweresignificantlyhigherintheleftventriculardiastolicdysfunctiongroupcomparedtothecontrolgroup(P0.05).AlinearcorrelationanalysisprovedthatbaPWVwerepositivelycorrelatedwithE/e(r=0.388,P=0.000),baPWVwerenegativeassociatedwithleftventriculardiastolicfunctioninessentialhypertension,thatisthehigherthebaPWVincreased,theworsewouldbeleftventriculardiastolicfunction.baPWVwerepositivel