摘要目的 采用心脏超声探析原发性高血压(EH)患者左室舒张功能障碍程度与左室几何构型改变的关系.方法 选取2017年7月至2019年4月于本院心脏超声科接受检查的EH患者265例,依据Ganau分型法将其分为A组(左心室构型正常,n=72)、B组(左心室向心性重构,n=58)、C组(左心室离心性肥厚,n=65)、D组(左心室向心性肥厚,n=70),比较4组患者临床资料及常规超声心动图参数、左心室舒张功能参数.结果 4组患者性别、年龄、心率、收缩压、舒张压及BMI比较,差异无统计学意义(均P＞0.05);与A组比较,B组左心房内径(LAD)、左心房舒张末内径(LVEDD)明显减小,C、D组明显增大(均P＜0.05),B、C、D组左心室后壁舒张末厚度(LV PWT)、室间隔舒张末厚度(IVST)均显著增加(均P＜0.05);与B组比较,C组LAD、LVEDD明显增大,LVPWT显著减少(均P＜0.05),D组LAD、LVEDD、IVST、LVPW均显著增加(均P＜0.05);与C组比较,D组LVEDD、LVPWT、IVST均显著增加,且C、D组左心室质量指数(LVMI)高于A、B组,A、C组相对室壁厚度(RWT)低于B、D组(均P＜0.05).与A组比较,反映左心室舒张功能的参数E/A、Em在B、C、D组均显著下降,而E/Em在D组显著增高,高于A、B、C组(均P＜0.05).结论 在EH患者中,左心室向心性肥厚患者的左室舒张功能障碍程度较左室离心性肥厚患者更严重,采用心脏超声检查可灵敏、准确地评估左室舒张功能.

abstractsObjective To investigate the relationship between severity of left ventricular diastolic dysfunction and alterations in left ventricular geometrical configuration in essential hypertension (EH) patients as detected by echocardiography.Methods A total of 265 EH patients who underwent echocardiography in our department between July 2017 and April 2019 were enrolled.According to Ganau classification,they were divided into group A (normal left ventricular configuration,n=72),group B (left ventricular centripetal remodeling,n=58),group C (left ventricular eccentric hypertrophy,n=65) and group D (left ventricular centripetal hypertrophy,n=70).The clinical data,routine echocardiographic parameters and left ventricular diastolic function indicators were compared among the 4 groups.Results There were no significant differences in gender,age,HR,SBP,DBP or BMI among the four groups (all P＞0.05).Compared with group A,LAD and LVEDD were lower in group B and greater in group C and group D (all P＜0.05).LVPWT and IVST in groups B,C and D were higher than those in group A (all P＜0.05).Compared with group B,the group C showed greater LAD and LVEDD but lower LVPWT (all P＜0.05),whereas all of these parameters were greater in group (all P＜0.05).Compared with group C,the LVEDD,LVPWT and IVST were greater in group D.The LVMI in group C and group D was higher than that in group A and group B.The RWT in group A and group C was lower than that in group B and group D (P＜ 0.05).Compared with group A,the left ventricular diastolic function indicators E/A and Em in groups B,C and D were lower.E/Em in group D was higher than that in group A,group B and group C (all P＜0.05).Conclusion In EH patients,left ventricular diastolic dysfunction is more severe in patients with left ventricular centripetal hypertrophy than in those with left ventricular eccentric hypertrophy.Use of echocardiography may sensitively and accurately evaluate the left ventricular diastolic function.