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目的 分析高血压病患者左心室的不同构型及其发生机制。方法 高血压病组 172例 ,对照组12 3例 ,以超声心动图测定左心室重量指数 (LVMI)和室壁相对厚度 (RWT) ;以彩色多普勒检测有无二尖瓣或主动脉瓣反流及其程度 ;以肱动脉血压和左心排血量计算体循环血管阻力 (SVR)。根据LVMI与RWT分析高血压病患者的左心室不同构型 ,并分析其彩色多普勒超声表现与SVR特征。结果 高血压病组左室正常型占49 .42 % ,向心性重构型 9.3 0 % ,向心性肥厚型 11.63 % ,离心性肥厚型 2 9.65 %。离心性肥厚组中度二尖瓣反流者较多。SVR最高者为向心性重构组 ,其次为向心性肥厚组 ,再次为左室正常组 ,三者与对照组比较差异均有显著意义 (P <0 .0 1)。结论 在高血压病患者中 ,离心性肥厚较向心性肥厚更为常见 ,向心性重构也占一定的比例。向心性肥厚及向心性重构主要与压力负荷过重有关 ;离心性肥厚既有压力负荷过重 ,又有容量负荷过重 ;向心性重构还可能与容量低负荷有关。
Objective To analyze the different configurations of left ventricular in hypertensive patients and its mechanism. Methods 172 cases of hypertension and 123 cases of control group were measured by echocardiography. The left ventricular mass index (LVMI) and the relative wall thickness (RWT) were measured. Color Doppler was used to detect the presence of mitral or aortic regurgitation Flow and its extent; Calculated systemic vascular resistance (SVR) using brachial artery blood pressure and left cardiac output. LVMI and RWT were used to analyze different left ventricular configurations in patients with essential hypertension, and their color Doppler ultrasound findings and SVR characteristics were analyzed. Results Hypertension group accounted for 49.42% of normal left ventricular, concentric remodeling 9.3 0%, centripetal hypertrophy 11.63%, centrifugal hypertrophy 2 9.65%. Centrifuge hypertrophy group more moderate mitral regurgitation. The highest SVR was concentric remodeling group, followed by centripetal hypertrophy group, once again normal left ventricle group, the three were significantly different from the control group (P <0.01). Conclusion In patients with hypertension, eccentric hypertrophy is more common than concentric hypertrophy, concentric remodeling also accounts for a certain proportion. Concentric hypertrophy and concentric remodeling are mainly related to stress overload; eccentric hypertrophy both overloaded with stress, but also capacity overload; concentric remodeling may also be related to capacity and low load.