CAJ | 학술논문

目的探讨老年高血压患者中心动脉压与动脉硬化及左心功能的关系. 方法 155例老年高血压患者,分为60～79岁组71例.80～95岁组84例.分别应用脉搏波分析仪计算中心动脉压及反射波增强指数;用全自动动脉硬化测量仪测定动脉硬化相关指标:臂踝脉搏波传导速度、踝臂指数、趾臂指数;用多普勒超声心动仪测定左心功能相关指标:舒张末期室间隔厚度、舒张末期左心室内径、舒张末期左心室后壁厚度、左心室相对厚度、左心室质量指数、二尖瓣前叶EF斜率、左心室射血分数、短轴缩短率. 结果 80～95岁组收缩压、脉压、中心动脉压、反射波增强指数、臂踝脉搏波传导速度均高于60～79岁组(P<0.05),踝臂指数、趾臂指数均低于60～79岁组(P<0.01).80～95岁组舒张末期室间隔厚度、舒张末期左心室后壁厚度、左心室相对厚度,左心室质量指数均高于60～79岁组(P<0.05),二尖瓣前叶EF斜率显著低于60～79岁组(P<0.05),舒张末期左心室内径、左心室射血分数、短轴缩短率两组阃差异无统计学意义(均P>0.05).经年龄、性别、体质指数、血糖、血脂、血尿酸、血肌酐调整后,中心动脉压与反射波增强指数、臂踝脉搏波传导速度呈正相关(r值分别为0.505和0.284,P<0.01);与踝臂指数、趾臂指数无相关性(P>0.05).中心动脉压与左心室肥厚及心功能指标舒张末期室间隔厚度、舒张末期左心室后壁厚度、左心室相对厚度、左心室质量指数亦呈正相关(P<0.05),而与二尖瓣前叶EF斜率呈负相关(P<0.01),与左心室射血分数、短轴缩短率、舒张末期左心室内径无相关性(P>0.05). 结论随年龄的增长,老年高血压患者中心动脉压升高,动脉硬化程度加重,并伴随左心室肥厚及舒张功能下降.中心动脉压可用于早期动脉硬化的诊断和筛查.
목적 탐토노년고혈압환자중심동맥압여동맥경화급좌심공능적관계. 방법 155례노년고혈압환자,분위60～79세조71례.80～95세조84례.분별응용맥박파분석의계산중심동맥압급반사파증강지수;용전자동동맥경화측량의측정동맥경화상관지표:비과맥박파전도속도、과비지수、지비지수;용다보륵초성심동의측정좌심공능상관지표:서장말기실간격후도、서장말기좌심실내경、서장말기좌심실후벽후도、좌심실상대후도、좌심실질량지수、이첨판전협EF사솔、좌심실사혈분수、단축축단솔. 결과 80～95세조수축압、맥압、중심동맥압、반사파증강지수、비과맥박파전도속도균고우60～79세조(P<0.05),과비지수、지비지수균저우60～79세조(P<0.01).80～95세조서장말기실간격후도、서장말기좌심실후벽후도、좌심실상대후도,좌심실질량지수균고우60～79세조(P<0.05),이첨판전협EF사솔현저저우60～79세조(P<0.05),서장말기좌심실내경、좌심실사혈분수、단축축단솔량조곤차이무통계학의의(균P>0.05).경년령、성별、체질지수、혈당、혈지、혈뇨산、혈기항조정후,중심동맥압여반사파증강지수、비과맥박파전도속도정정상관(r치분별위0.505화0.284,P<0.01);여과비지수、지비지수무상관성(P>0.05).중심동맥압여좌심실비후급심공능지표서장말기실간격후도、서장말기좌심실후벽후도、좌심실상대후도、좌심실질량지수역정정상관(P<0.05),이여이첨판전협EF사솔정부상관(P<0.01),여좌심실사혈분수、단축축단솔、서장말기좌심실내경무상관성(P>0.05). 결론 수년령적증장,노년고혈압환자중심동맥압승고,동맥경화정도가중,병반수좌심실비후급서장공능하강.중심동맥압가용우조기동맥경화적진단화사사.
Objective To evaluate the relationship of central aortic pressure (CAP) with atherosclerosis and left ventricular function in elderly patients with essential hypertension. Methods A total of 155 elderly hypertensive patients were divided into two groups: aged 60-79 years group (n = 71) and aged 80-95 years group (n= 84). Central aortic waveforms were generated using pulse wave analysis, then CAP and augmentation index (AI) were determined. Auto-survey atherosclerosis apparatus was applied to examine brachial-ankle pulse wave velocity (baPWV), ankle-brachial index (ABI) and toe-brachial index (TBI). Interventricular septal thickness at end diastole (IVSd), left ventricular end-diastolic dimension (LVDd), left ventricular posterior wall thickness at end diastole (LVPWd), relative left ventricle thickness (RLVT), left ventricular mass index (LVMI), Ejection fraction(EF) slope, left ventricle ejection fraction (LVEF) and fractional shortening (FS) were measured by the two-dimensional echoeardiography. Results Systolic pressure (SBP), pulse pressure (PP), CAP, AI and baPWV were significantly higher in aged 80-95 years group than in aged 60-79 years group (all P<0.05), ABI and TBI were significantly lower oppositely (both P<0. 01). IVSd, LVPWd, RLVT and LVMI were all significantly higher and EF slope was lower in aged 80-95 years group than in aged 60-79 years group (all P<0. 057. There were no significant differences in LVDd, LVEF and FS between the two groups (both P>0. 05). CAP had positive association with PP, AI and baPWV (r=0. 505,0. 284,all P<0.01). After adjustment for age, gender, smoking, body mass index, fasting blood sugar, creatinine, uric acid, cholesterol, triglyceride, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol, there was no significant relationship between CAP and ABI or TBI (both P>0. 05). There was also positive association of CAP with IVSd, LVPWd, RLVT, LVMI, while negative associations of CAP with EF slope (all P<0. 01). There were no significant relationship between CAP and LVEF, FS, LVDd (all P> 0.05). Conclusions CAP and degree of artherosclerosis increase with aging in elderly patients with essential hypertension, which contributes to left ventricular hypertrophy and the decreased diastolic function. CAP helps to make an early diagnosis of or screening arteriosclerosis, and it is an important forecast factor for cardiovascular disease.