中华内分泌代谢杂志
中華內分泌代謝雜誌
중화내분비대사잡지
CHINESE JOURNAL OF ENDOCRINOLOGY AND METABOLISM
2012年
2期
117-120
,共4页
李南方%李红建%王红梅%王梦卉%周克明%张德莲%祖菲亚%欧阳玮琏
李南方%李紅建%王紅梅%王夢卉%週剋明%張德蓮%祖菲亞%歐暘瑋璉
리남방%리홍건%왕홍매%왕몽훼%주극명%장덕련%조비아%구양위련
原发性醛固酮增多症%左室肥厚%左室构型
原髮性醛固酮增多癥%左室肥厚%左室構型
원발성철고동증다증%좌실비후%좌실구형
Primary aldosteronism%Left ventricular hypertrophy%Left ventricular geometrical patterns
目的 探讨原发性醛固酮增多症(PA)患者左室结构损害的特点.方法 将2007年1月至2010年6月住院行PA筛查最终确诊为PA(213例)及原发性高血压(EH)的患者(225例)纳入研究,依据超声心动图结果评价两组患者的左室结构.结果 PA组的病程、醛固酮水平明显高于EH组(P＜0.01),而血钾、肾素活性明显低于EH组(P＜0.01).协方差分析校正病程后,PA组患者的室间隔厚度、左室舒张末期内径、左室重量指数、左室舒张末期容积和每搏输出量均高于EH组(P＜0.01).PA组患者左室肥厚的发生率明显高于EH组(53.1％对33.8％,x2=16.57,P＜0.01)；PA组患者正常构型、向心性重构、向心性肥厚及离心性肥厚的构成比分别是:24.9％、22.1％、22.1％和30.9％.多元逐步回归分析显示收缩压、坐位醛固酮水平是影响PA患者左室重量指数的主要因素,回归系数分别为0.45 (P＜0.01)、0.43 (P＜0.01)；病程是影响相对室壁厚度的主要因素,回归系数是0.011 (P＜0.05).结论 PA患者左室肥厚的发生率高于EH患者,其左室构型以离心性肥厚最多见.
目的 探討原髮性醛固酮增多癥(PA)患者左室結構損害的特點.方法 將2007年1月至2010年6月住院行PA篩查最終確診為PA(213例)及原髮性高血壓(EH)的患者(225例)納入研究,依據超聲心動圖結果評價兩組患者的左室結構.結果 PA組的病程、醛固酮水平明顯高于EH組(P＜0.01),而血鉀、腎素活性明顯低于EH組(P＜0.01).協方差分析校正病程後,PA組患者的室間隔厚度、左室舒張末期內徑、左室重量指數、左室舒張末期容積和每搏輸齣量均高于EH組(P＜0.01).PA組患者左室肥厚的髮生率明顯高于EH組(53.1％對33.8％,x2=16.57,P＜0.01)；PA組患者正常構型、嚮心性重構、嚮心性肥厚及離心性肥厚的構成比分彆是:24.9％、22.1％、22.1％和30.9％.多元逐步迴歸分析顯示收縮壓、坐位醛固酮水平是影響PA患者左室重量指數的主要因素,迴歸繫數分彆為0.45 (P＜0.01)、0.43 (P＜0.01)；病程是影響相對室壁厚度的主要因素,迴歸繫數是0.011 (P＜0.05).結論 PA患者左室肥厚的髮生率高于EH患者,其左室構型以離心性肥厚最多見.
목적 탐토원발성철고동증다증(PA)환자좌실결구손해적특점.방법 장2007년1월지2010년6월주원행PA사사최종학진위PA(213례)급원발성고혈압(EH)적환자(225례)납입연구,의거초성심동도결과평개량조환자적좌실결구.결과 PA조적병정、철고동수평명현고우EH조(P＜0.01),이혈갑、신소활성명현저우EH조(P＜0.01).협방차분석교정병정후,PA조환자적실간격후도、좌실서장말기내경、좌실중량지수、좌실서장말기용적화매박수출량균고우EH조(P＜0.01).PA조환자좌실비후적발생솔명현고우EH조(53.1％대33.8％,x2=16.57,P＜0.01)；PA조환자정상구형、향심성중구、향심성비후급리심성비후적구성비분별시:24.9％、22.1％、22.1％화30.9％.다원축보회귀분석현시수축압、좌위철고동수평시영향PA환자좌실중량지수적주요인소,회귀계수분별위0.45 (P＜0.01)、0.43 (P＜0.01)；병정시영향상대실벽후도적주요인소,회귀계수시0.011 (P＜0.05).결론 PA환자좌실비후적발생솔고우EH환자,기좌실구형이리심성비후최다견.
Objective To investigate the characteristics of left ventricular structural damage in patients with primary aldosteronism(PA).Methods A total of 438 inpatients with hypertension from January 2007 to June 2010 were screened for PA,and diagnosis was made in 213 PA patients and 225 patients with essential hypertension (EH).The left ventricular structure of all subjects was evaluated according to the results of echocardiographic measurements.Results The duration of hypertension and plasma aldosterone level in patients with PA were significantly higher (P＜ 0.01 ),while the serum potassium and plasma renin activity were significantly lower (P＜0.01 ) than those in patients with EH.The interventricular septum thickness,left ventricular end-diastolic dimension,left ventricular mass index (LVMI),left ventricular end-diastolic volume,and stroke volume in patients with PA were significantly higher than those in EH patients( P＜0.01 ) after the duration of hypertension was corrected.In patients with PA,the prevalence of left ventricular hypertrophy (LVH) was higher than that in EH patients ( 53.1％ vs 33.8 ％,x2 =16.57,P ＜ 0.01 ). Normal left ventricular geometry ( NG ),concentric remodeling ( CCR ),concentric hypertrophy( CCH),and eccentric hypertrophy (ECH) were found respectively in 24.9％,22.1％,22.1％,and 30.9％ of patients with PA.Multiple stepwise regression analysis showed that the seated plasma aldosterone level (β=0.43,P ＜ 0.01 ) and systolic blood pressure (β =0.45,P ＜ 0.01 ) were the main factors that influenced LVMI.The course was the main parameter that influenced relative wall thickness(β=0.011,P＜0.05 ).Conclusion The prevalence of LVH is higher in patients with PA than that in EH patients.The eccentric hypertrophy is the most common left ventricular geometrical pattern in patients with PA.
