老年高血压患者体位性血压变化与左室结构及功能关系的研究

发布时间：2018-08-20 11:20

【摘要】：探讨老年原发性高血压患者体位性血压变化与左室结构及功能的关系。选取2015年3月至2017年1月在锦州医科大学附属第一医院心内科、老年病房住院及门诊≥60岁原发性高血压患者126例,分为体位性低血压(OH)组、体位性血压正常(ONT)组、体位性高血压(OHT)组三组。观察三组患者左心室舒张末期内径(LVEDD)、左心室后壁厚度(LVPWT)、室间隔厚度(IVST)、左心室射血分数(EF)、左心室短轴缩短率(FS)的心脏超声指标,并计算左心室质量指数(LVMI),分析老年原发性高血压患者体位性血压变化与左室结构及功能的关系。结果显示,与ONT组比较,老年高血压患者合并OH和OHT组的年龄、高血压病程明显升高,差异有统计学意义(P0.05);与ONT和OHT组比较,OH组LVEDD、IVST、LVPWT、LVMI值均升高,差异有统计学意义(P0.05),OH组EF、FS值均降低,差异有统计学意义(P0.05);协方差分析剔除年龄和高血压病程因素影响,OH组患者的LVMI仍明显升高(P0.05),EF、FS值仍明显降低(P0.05)。提示老年高血压患者合并OH与左室结构和功能有相关性,提示OH可加重左室结构改变和功能损害。
[Abstract]:To explore the relationship between the changes of postural blood pressure and left ventricular structure and function in elderly patients with essential hypertension.126 patients with essential hypertension aged over 60 years old were selected from the Department of Cardiology, First Affiliated Hospital of Jinzhou Medical University from March 2015 to January 2017.They were divided into orthostatic hypotension (OH) group and normal postural blood pressure (ONT) group. The left ventricular end-diastolic diameter (LVEDD), left ventricular posterior wall thickness (LVPWT), ventricular septal thickness (IVST), left ventricular ejection fraction (EF), left ventricular short-axis shortening rate (FS) and left ventricular mass index (LVMI) were observed and analyzed in elderly patients with essential hypertension. Compared with ONT and OHT group, LVEDD, IVST, LVPWT and LVMI in OH group were higher, and EF and FS values in OH group were lower and worse than those in ONT and OHT group (P 0.05). Covariance analysis excluded the influence of age and hypertension course factors, the LVMI of OH group was still significantly higher (P 0.05), EF and FS values were still significantly lower (P 0.05). It suggested that OH in elderly hypertensive patients was correlated with left ventricular structure and function, suggesting that OH could aggravate left ventricular structure and function damage.
【作者单位】：锦州医科大学附属第一医院老年医学科;
【分类号】：R544.1

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