脉压与冠心病患者左室功能及左室肥厚的关系

作者:戴秋艳;孙宝贵;吴雪英;吴莹;汪玮 刊名:中国临床康复 上传者:曾映辉

【摘要】目的:比较分析合并与未合并糖尿病、高血压冠心病患者脉压与心功能指标及左室肥厚的关系。方法:①选择2001-01/12上海交通大学附属第一人民医院心内科住院冠心病患者105例,男70例,女35例。其中仅合并高血压者29例(合并高血压组),同时合并高血压及糖尿病者27例(合并高血压及糖尿病组),合并糖尿病者32例(合并糖尿病组),无高血压及糖尿病者(无高血压及糖尿病组)17例。患者均知情同意。②在行冠状动脉造影术过程中测定主动脉内收缩压、舒张压,计算脉压值。超声心动描记法为M型模式下测定舒张末期左室腔直径、左室后壁厚度及室间隔厚度及左室射血分数。根据公式:左室质量=1.04[(室间隔厚度+舒张末期左室腔直径+左室后壁厚度)3-舒张末期左室腔直径3]-13.6计算左室质量。根据公式:相对室壁厚度=(室间隔厚度+左室后壁厚度)/舒张末期左室腔直径计算相对室壁厚度。③分别以脉压、左室质量、左室射血分数及相对室壁厚度为变量,以年龄、性别、伴有高血压、伴有糖尿病、同时伴有高血压及糖尿病为控制变量,进行偏相关分析。组间分析采用方差分析。结果:冠心病105例均进入结果分析。①各组脉压无明显差别。合并高血压及糖尿病组左室质量、相对室壁厚度大于其他3组(P<0.05),心功能指标左室射血分数明显低于其他3组(P<0.05)。②各组脉压均与左室质量呈显著正相关(r=0.35~0.47,P<0.05~0.01)。合并高血压组、合并高血压及糖尿病组脉压与左室射血分数呈显著正相关(r=0.33,0.41P<0.05)。合并高血压及糖尿病组脉压与相对室壁厚度呈显著正相关(r=0.51,P<0.01)。结论:脉压是一独立于高血压之外的,与左室肥厚有关的独立指标;同时合并高血压及糖尿病,为影响冠心病患者左室肥厚,左室收缩功能的重要因素。

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42 中国临床康复第9卷第JJ朋2005-08-21出版 Chinese Journal of Clinical Rehabilitation,A ugust 21 2005 V01.9 No.31 脉压与冠心病患者左室功能及左室肥厚的关系☆ 戴秋艳,孙宝贵,吴雪英,吴莹,汪玮 ·基础研究· 上海交通大学附属第一人民医院心内科,上海市200080 戴秋艳☆,女,1962年生,河北省唐山市人,汉族,1997年上海第二医科 大学毕业,博士,副主任医师,主要从事高血压及冠心病的诊治研究。 daiqiuyan@medmail.com.cn 中图分类号:R541.4 文献标识码:A文章编号:1671-5926(2005)31-0042—02 收稿日期:2004—11-08修回日期:2004—12—07(12/NH/YL) Association of pulse pressure with left ventricular function and left ventricular hypertrophy in patients with coronary heart disease Dai Qiu—yan,Sun Bao—gui,Wu Xue—ying,Wu Ying, Wang Wei,Department of Cardiology,First People’s Hospital。Shahghai Jiaotong University,Shanghai 200080,China Dai Oiu—yan☆,M.D.,Associate chief physician.Department of Cardiology。 First People’s Hospital,Shanghai Jiaotong University,Shanghai 200080, China daiqiuyan@medmail.com.en Received:2004一ll一08 Accepted:2004—12—07 Abstract AⅡ江:To compare and analyze the correlation of pulse pressure with left ventricular function and left ventrieular hypertrophy in coronary heart dis— ease patients with and without diabetes mellitus and hypertension. M哐THoDS:(D Totally 105 inpatients f70 males and 35 females)with coronary heart disease were selected from the Department of Cardiology,the First People’s Hospital of Shanghai Jiaotong University between Jan— uary and December 2001. including 29 cases were only accompanied by hypertension(accompanied by hypertension group),27 cases were accom— panied by both hypertension and diabetes mellitus(accompanied by hyper-

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