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目的探讨原发性高血压患者主动脉重构和左心房重构相关的诸因素变化特点及相互关系。方法选择924例原发性高血压患者,根据主动脉及左心房是否重构扩大分为主动脉增宽左心房增大组、主动脉增宽左心房正常组、左心房增大主动脉正常组、主动脉正常左心房正常组,分别测量各组患者的左房收缩末期内径(LADs)、主动脉窦部内径、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),并计算左心室心肌重量指数(LVMI)等指标。结果主动脉增宽左心房增大组患者的年龄(57.52±14.70)岁、LVMI(138.61±43.02)g/m~2、收缩压(149.79±16.57)mmHg、舒张压(95.91±15.34)mmHg、病程(8.79±6.50)a均大于主动脉正常左房正常组(P<0.05)。主动脉增宽左房正常组患者的年龄(59.53±12.22)岁、收缩压(141.93±15.89)mmHg、病程(7.75±6.74)a大于主动脉正常左心房正常组(P<0.05),主动脉增宽左房正常组患者年龄(59.53±12.22)岁大于主动脉正常左房增大组患者(P<0.05)。主动脉正常左心房增大组患者的体质指数(BMI)(27.39±3.48)kg/m~2、LVMI(129.97±40.34)g/m~2、舒张压(92.94±15.94)mmHg均大于主动脉正常左房正常组(P<0.05),主动脉正常左心房增大组患者LVMI(129.97±40.34)g/m~2大于主动脉增宽左房正常组(P<0.05)。ROC曲线示,在影响患者主动脉重构的众多因素中,年龄所占曲线下面积最大(0.68),在影响患者左心房重构的众多因素中,LVMI所占曲线下面积最大(0.71)。结论年龄和LVMI分别是主动脉重构和左房重构的最重要影响因素。
Objective To investigate the characteristics and correlation of the changes of aortic remodeling and left atrial remodeling in patients with essential hypertension. Methods A total of 924 patients with essential hypertension were enrolled in this study. According to whether the aorta and left atrium were remodeled or not, the aorta widening left atrium enlargement group, the aorta widening left atrium normal group, the left atrium increasing aorta normal group , Aortic normal left atrium normal group were measured in each group of left atrial end systolic diameter (LADs), aortic sinus diameter, left ventricular end-diastolic diameter (LVEDd), diastolic ventricular septum and left ventricular posterior wall thickness ( IVSd, LVPWd), and calculate the left ventricular myocardial mass index (LVMI) and other indicators. Results The age of patients with aortic enlargement of the left atrium (57.52 ± 14.70), LVMI (138.61 ± 43.02) g / m 2, systolic pressure (149.79 ± 16.57) mmHg and diastolic pressure (95.91 ± 15.34) mmHg, The course of disease (8.79 ± 6.50) a was greater than that of the normal aorta normal left atrium group (P <0.05). The aorta widened the age of normal left atrium patients (59.53 ± 12.22) years, systolic blood pressure (141.93 ± 15.89) mmHg, the duration of (7.75 ± 6.74) a was greater than that of aorta normal left atrium normal group (P0.05) Patients with normal left ventricular enlargement (59.53 ± 12.22) years old were larger than those with normal left atrial enlargement (P <0.05). The body mass index (BMI) (27.39 ± 3.48) kg / m ~ 2, LVMI (129.97 ± 40.34) g / m ~ 2 and diastolic blood pressure (92.94 ± 15.94) mmHg in patients with normal aorta left atrium were higher than those in the aorta Normal left atrium normal group (P <0.05), aortic normal left atrium enlargement group LVMI (129.97 ± 40.34) g / m ~ 2 than aortic enlargement left atrial normal group (P <0.05). The ROC curve showed that the area under the curve of age was the largest (0.68) among the many factors influencing aortic remodeling. The area under the curve of LVMI was the largest (0.71) among the many factors influencing left atrial remodeling in patients. Conclusion Age and LVMI are the most important influential factors of aortic remodeling and left atrium remodeling, respectively.