中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2013年
10期
1028-1032
,共5页
原发性高血压%醛固酮%纤维蛋白原%D-二聚体%左心室肥厚
原髮性高血壓%醛固酮%纖維蛋白原%D-二聚體%左心室肥厚
원발성고혈압%철고동%섬유단백원%D-이취체%좌심실비후
Essential%hypertension%Aldosterion%Fibrinogen%D-dimer%Left%ventricular%hypertrophy
目的 探讨原发性高血压患者血浆醛固酮、纤维蛋白原浓度变化与左心室质量的关系.方法 选取273例原发性高血压患者,抽取肘静脉血进行相关生化指标的检测,如应用放射免疫法检测血浆醛固酮浓度、酶联免疫吸附法检测纤维蛋白原浓度,免疫比浊法测定D-二聚体浓度.应用超声心动图检查患者的心脏结构和功能进行评估.按照纤维蛋白原浓度的三分位数分为低值(A组)95例、中值(B组)87例、高值(C组)91例共3组,对3组的一般临床资料、生化检测指标、超声心动图检测结果进行比较分析；并比较血浆醛固酮平均值≥125 pmol/L或＜125 pmol//L两种不同浓度下3组左心室质量指数的差异.结果 血浆醛固酮明显增高(≥125 pmol/L)患者的左心室质量指数(LVMI)明显增大,A、B、C3组左心室质量指数依次增加[分别为(35.0±3.1)、(45.0±3.6)、(51.0±2.9)g/m2],3组比较差异有统计学意义(F=6.65,P＜0.01),尤其C组患者中醛固酮浓度≥125 pmol/L者左心室质量增加更明显,与醛固酮＜ 125 pmol/L的患者相比差异有统计学意义(t=11.65,P＜0.01).3组纤蛋白原浓度逐渐增高,分别为2630(2420 ～2790)、3290(3170 ～3430)、4210(3791 ～4580),C组与其他两组比较差异有统计学意义(Z=-2.46,P＜0.01).超声心动图检测结果提示C组较A、B组左心室直径增大[A、B、C组分别为(20.0±2.3)、(22.0±3.9)、(23.0±3.1)mm/m2,F=8.16,P＜0.05],室间隔厚度增加[A、B、C组分别为(9.2±1.9)、(10.1±2.0)、(10.5±2.4)mm,F=10.52,P＜0.01],左心室后壁厚度增大[A、B、C组分别为(8.8±1.5)、(9.2±1.6)、(9.7±1.7)mm,F=10.6,P＜0.01],左心室质量指数增加[A、B、C组分别为(37±9)、(43±11)、(45±13) g/m2,F=11.6,P＜0.01].结论 原发性高血压患者血浆纤维蛋白原和醛固酮浓度的增高与左心室质量指数有关,二者相互作用共同参与左心室肥厚的发生.
目的 探討原髮性高血壓患者血漿醛固酮、纖維蛋白原濃度變化與左心室質量的關繫.方法 選取273例原髮性高血壓患者,抽取肘靜脈血進行相關生化指標的檢測,如應用放射免疫法檢測血漿醛固酮濃度、酶聯免疫吸附法檢測纖維蛋白原濃度,免疫比濁法測定D-二聚體濃度.應用超聲心動圖檢查患者的心髒結構和功能進行評估.按照纖維蛋白原濃度的三分位數分為低值(A組)95例、中值(B組)87例、高值(C組)91例共3組,對3組的一般臨床資料、生化檢測指標、超聲心動圖檢測結果進行比較分析；併比較血漿醛固酮平均值≥125 pmol/L或＜125 pmol//L兩種不同濃度下3組左心室質量指數的差異.結果 血漿醛固酮明顯增高(≥125 pmol/L)患者的左心室質量指數(LVMI)明顯增大,A、B、C3組左心室質量指數依次增加[分彆為(35.0±3.1)、(45.0±3.6)、(51.0±2.9)g/m2],3組比較差異有統計學意義(F=6.65,P＜0.01),尤其C組患者中醛固酮濃度≥125 pmol/L者左心室質量增加更明顯,與醛固酮＜ 125 pmol/L的患者相比差異有統計學意義(t=11.65,P＜0.01).3組纖蛋白原濃度逐漸增高,分彆為2630(2420 ～2790)、3290(3170 ～3430)、4210(3791 ～4580),C組與其他兩組比較差異有統計學意義(Z=-2.46,P＜0.01).超聲心動圖檢測結果提示C組較A、B組左心室直徑增大[A、B、C組分彆為(20.0±2.3)、(22.0±3.9)、(23.0±3.1)mm/m2,F=8.16,P＜0.05],室間隔厚度增加[A、B、C組分彆為(9.2±1.9)、(10.1±2.0)、(10.5±2.4)mm,F=10.52,P＜0.01],左心室後壁厚度增大[A、B、C組分彆為(8.8±1.5)、(9.2±1.6)、(9.7±1.7)mm,F=10.6,P＜0.01],左心室質量指數增加[A、B、C組分彆為(37±9)、(43±11)、(45±13) g/m2,F=11.6,P＜0.01].結論 原髮性高血壓患者血漿纖維蛋白原和醛固酮濃度的增高與左心室質量指數有關,二者相互作用共同參與左心室肥厚的髮生.
목적 탐토원발성고혈압환자혈장철고동、섬유단백원농도변화여좌심실질량적관계.방법 선취273례원발성고혈압환자,추취주정맥혈진행상관생화지표적검측,여응용방사면역법검측혈장철고동농도、매련면역흡부법검측섬유단백원농도,면역비탁법측정D-이취체농도.응용초성심동도검사환자적심장결구화공능진행평고.안조섬유단백원농도적삼분위수분위저치(A조)95례、중치(B조)87례、고치(C조)91례공3조,대3조적일반림상자료、생화검측지표、초성심동도검측결과진행비교분석；병비교혈장철고동평균치≥125 pmol/L혹＜125 pmol//L량충불동농도하3조좌심실질량지수적차이.결과 혈장철고동명현증고(≥125 pmol/L)환자적좌심실질량지수(LVMI)명현증대,A、B、C3조좌심실질량지수의차증가[분별위(35.0±3.1)、(45.0±3.6)、(51.0±2.9)g/m2],3조비교차이유통계학의의(F=6.65,P＜0.01),우기C조환자중철고동농도≥125 pmol/L자좌심실질량증가경명현,여철고동＜ 125 pmol/L적환자상비차이유통계학의의(t=11.65,P＜0.01).3조섬단백원농도축점증고,분별위2630(2420 ～2790)、3290(3170 ～3430)、4210(3791 ～4580),C조여기타량조비교차이유통계학의의(Z=-2.46,P＜0.01).초성심동도검측결과제시C조교A、B조좌심실직경증대[A、B、C조분별위(20.0±2.3)、(22.0±3.9)、(23.0±3.1)mm/m2,F=8.16,P＜0.05],실간격후도증가[A、B、C조분별위(9.2±1.9)、(10.1±2.0)、(10.5±2.4)mm,F=10.52,P＜0.01],좌심실후벽후도증대[A、B、C조분별위(8.8±1.5)、(9.2±1.6)、(9.7±1.7)mm,F=10.6,P＜0.01],좌심실질량지수증가[A、B、C조분별위(37±9)、(43±11)、(45±13) g/m2,F=11.6,P＜0.01].결론 원발성고혈압환자혈장섬유단백원화철고동농도적증고여좌심실질량지수유관,이자상호작용공동삼여좌심실비후적발생.
Objective To investigate the relationship between plasma fibrinogen levels,aldosterion levels and left ventricular mass in patients with essential hypertension.Methods Two hundred and seventy-three patients with essential hypertension were selected as subjects.Eldow vonous blood sample were taken to measure the rennin,aldosterion,fibrinogen,D-dimer,prothrombin fragment 1 + 2 (F1 + 2),and plasminogen activator inhibitor-1 (PAI-1) concentration by radioimmunoassay.And assessed cardiac structure and function in patients ultrasound heartbeat by application of ultrasound heartbeat.According to fibrinogen levels,all patients were divided to low(A group,n =95),medium (B group,n =87) and highest (C group,n =91) groups,and comparative analyzed the general clinical data,biochemical indexes,ultrasound heartbeat graph test results of the 3 groups.Meanwhile to compare the differences between 3 groups of left ventricular mass index on the two different concentrations of plasma aldosterone average ≥ 125 pmol/L or ＜ 125 pmol/L.Results Left ventricular mass index (LVMI) increased in patients with aldosterone levels ≥ 125 pmol/L as the plasma aldosterone increased significantly.The left ventricular mass index in A,B,C group were (35.0 ± 3.1),(45.0 ± 3.6),(51.0 ± 2.9) g/m2 respectively,the difference between the 3 groups have statistical significance (F =6.65,P ＜ 0.01).Within C group,LVMI in patients with aldosterone concentration(≥ 125 pmol/L) was greater than ＜ 125 pmol/L(t =11.65,P ＜ 0.01).Meanwhile the fibrinogen concentration gradually increased in A,B and C group (2630 (2420-2790),3290 (3170-3430),4210 (3791-4580),respectively).Fibrinogen concentration in C group was higher than that in the other two groups (Z =-2.46,P ＜ 0.01).Ultrasonic heartbeat graph examination Results showed that left ventricular diameter in C group was the biggest than that in A and B groups (A,B,C group were (20.0 ± 2.3),(22.0 ± 3.9),(23.0 ± 3.1) mm/m2 respectively,F =8.16,P ＜ 0.05);The same trends were also seen regarding of interventricular septal thickness (A,B,C group were(9.2 ± 1.9),(10.1 ± 2.0),(10.5 ± 2.4) mm respectively,F =10.52,P ＜ 0.01),left ventricular posterior wall thickness (A,B,C group were (8.8 ± 1.5),(9.2 ± 1.6),(9.7 ± 1.7) mm respectively,F =10.6,P＜0.01) and left ventricular mass(A,B,C group were(37 ±9),(43 ± 11),(45 ± 13) g/m2 respectively,F =11.6,P ＜ 0.01).Conclusion Plasma fibrinogen and aldosterone concentrations are associated with left ventricular mass in patients with essential hypertension.Both them of interaction and participate to left ventricular hypertrophy commonly.
