目的应用超声心动图评价不同级别中老年高血压患者二尖瓣舒张期血流速度对左心房重构的影响。方法 816例原发性高血压患者,按高血压分级标准分为1、2、3级,根据二尖瓣舒张期峰值血流速度E/A比值分为E/A>1和E/A<1,又根据年龄分为中年组和老年组,分别测量各组患者的左房收缩末期内径(LADs)、左心室舒张末期内径(LVEDd),舒张期室间隔及左室后壁厚度(IVSd、LVPWd)并计算左心室质量指数(LVMI)等指标。结果在高血压各级别中,E/A<1组左房内径指数(LADi)、LVMI、脉压、病程均随着年龄的增大而增大(P<0.05)。E/A>1组LADi、脉压、病程均随着年龄增加而增大(P<0.05)。两组的收缩压、舒张压均随着年龄的增加而减小,且任意一级高血压E/A<1组的LADi均高于E/A>1组(P<0.05)。在高血压各年龄段中,E/A<1组和E/A>1组LADi、收缩压、舒张压、脉压均随着高血压级别的增加而增大(P<0.05)。1级高血压中年组E/A比值与LADi、LVMI无相关性,老年组E/A比值与LADi相关(r=-0.263,P=0.025),2级高血压中年和老年组的E/A比值均与LADi相关(r=-0.376,P=0.000;r=-0.243,P=0.027),3级高血压中年组E/A比值与LADi相关,而老年组E/A比值不仅与LADi相关,与LVMI也显著相关(r=-0.391,P=0.000;r=0.316,P=0.004)。结论随高血压级别的加重,中年组E/A仅与左房重构相关,而老年组E/A与左房和左室重构均相关。 Objective To evaluate the effect of mitral diastolic velocity on left atrial remodeling in patients with different grades of middle-aged and elderly patients with hypertension. Methods Totally 816 patients with essential hypertension were divided into two groups according to the classification criteria of hypertension. E / A> 1 and E / A < 1, and divided into middle-aged group and old group according to age, measured the left atrium end systolic diameter (LADs), left ventricular end diastolic diameter (LVEDd), diastolic ventricular septum and left ventricular posterior wall thickness (IVSd , LVPWd) and calculate the left ventricular mass index (LVMI) and other indicators. Results In all levels of hypertension, LADi, LVMI, pulse pressure and duration of E / A <1 group increased with age (P <0.05). LADi, pulse pressure and duration of E / A> 1 group increased with age (P <0.05). Systolic and diastolic blood pressure decreased with age in both groups, and LADi in E / A <1 group was higher than that in E / A> 1 group (P <0.05). In all age groups, LADi, systolic blood pressure, diastolic blood pressure and pulse pressure of E / A <1 and E / A> 1 groups increased with the increase of hypertension (P <0.05). The E / A ratio of grade 1 hypertension middle age group had no correlation with LADi and LVMI, but the E / A ratio of elderly patients was correlated with LADi (r = -0.263, P = 0.025) / A ratio was associated with LADi (r = -0.376, P = 0.000; r = -0.243, P = 0.027). The E / A ratio of grade 3 hypertension middle age group was correlated with LADi, while the elderly group E / A ratio not only Associated with LADi was also significantly associated with LVMI (r = -0.391, P = 0.000; r = 0.316, P = 0.004). Conclusion With the aggravation of hypertension, E / A in middle age group is only related to left atrial remodeling. E / A in elderly group is correlated with left atrium and left ventricular remodeling.