CAJ | 학술논문

目的探讨外周血管动脉粥样硬化与心脏舒张功能的相关性.方法选取2012年11月至2013年10月于北京安贞医院就诊的235例老年患者,所有患者均经血管超声检查发现存在外周动脉粥样硬化斑块,根据心脏舒张功能将患者分为轻度舒张功能不全组(114例)和中度舒张功能不全组(131例).测量并比较2组患者肱踝脉搏传导速度(baPWV)、踝臂指数、心脏舒张功能指标,对baPWV、踝臂指数与心脏舒张功能相关性做Spearman相关分析.结果 2组患者baPWV、踝臂指数比较差异无统计学意义(P＞0.05);轻度舒张功能不全组心脏舒张功能指标舒张早期二尖瓣血流速度峰值/舒张晚期二尖瓣血流速度峰值(E/A)和E/舒张早期二尖瓣环运动速度(E/E’)均与baPWV和踝臂指数明显相关,E/A与二者的相关系数分别为-0.682、-0.512;E/E’与二者的相关系数分别为0.724、0.553(P ＜0.05).在中度舒张功能不全组中,E/A和E/E’与baPWV和踝臂指数均无明显相关性(P＞0.05).在其他影响因素中,年龄及血尿酸水平均分别与E/A和E/E'相关,E/A与其相关系数分别为-0.452、-0.434;E/E'与其相关系数分别为0.522、0.487(P＜0.05).结论早期心脏出现舒张功能不全时,心脏的舒张功能与外周血管弹性之间存在较好的功能偶联关系;随舒张功能进一步受损,心脏与血管偶联关系失衡,心脏功能受到包括年龄、血尿酸水平等多种因素的影响.
목적 탐토외주혈관동맥죽양경화여심장서장공능적상관성.방법 선취2012년11월지2013년10월우북경안정의원취진적235례노년환자,소유환자균경혈관초성검사발현존재외주동맥죽양경화반괴,근거심장서장공능장환자분위경도서장공능불전조(114례)화중도서장공능불전조(131례).측량병비교2조환자굉과맥박전도속도(baPWV)、과비지수、심장서장공능지표,대baPWV、과비지수여심장서장공능상관성주Spearman상관분석.결과 2조환자baPWV、과비지수비교차이무통계학의의(P＞0.05);경도서장공능불전조심장서장공능지표서장조기이첨판혈류속도봉치/서장만기이첨판혈류속도봉치(E/A)화E/서장조기이첨판배운동속도(E/E’)균여baPWV화과비지수명현상관,E/A여이자적상관계수분별위-0.682、-0.512;E/E’여이자적상관계수분별위0.724、0.553(P ＜0.05).재중도서장공능불전조중,E/A화E/E’여baPWV화과비지수균무명현상관성(P＞0.05).재기타영향인소중,년령급혈뇨산수평균분별여E/A화E/E'상관,E/A여기상관계수분별위-0.452、-0.434;E/E'여기상관계수분별위0.522、0.487(P＜0.05).결론 조기심장출현서장공능불전시,심장적서장공능여외주혈관탄성지간존재교호적공능우련관계;수서장공능진일보수손,심장여혈관우련관계실형,심장공능수도포괄년령、혈뇨산수평등다충인소적영향.
Objective To evaluate the correlation between peripheral arterial atherosclerosis and cardiac diastolic function.Methods Totally 235 elderly patients with peripheral arterial atherosclerotic plaque diagnosed by ultrasound were enrolled and divided into mild dysfunction group (114 cases) and moderated dysfunction group (131 cases) according to the cardiac diastolic dysfunction grade.The brachial-ankle pulse wave-velocity (baPWV),ankle-brachial index (ABI) and cardiac diastolic function were assessed and compared between the two groups.The Spearman analysis was performed to evaluate the correlation between cardiac diastolic function with baPWV and ABI.Results There were no significant differences in baPWV and ABI between the two groups (P ＞ 0.05).In mild dysfunction group,the indices of cardiac diastolic function such as mitral valve peak early diastolic blood flow velocity/mitral valve late diastolic flow velocity (E/A) and E/mitral annulus velocity (E/E') were both correlated with baPWV (r =-0.682,0.724) and ABI (r =-0.512,0.553) (P ＜ 0.05).In moderate dysfunction group,E/A and E/E'were not correlated with baPWV and ABI (P ＞ 0.05),while were correlated with age (r =-0.452,0.522) and uric acid (r =-0.434,0.487) (P ＜ 0.05).Conclusion The cardiac diastolic function shows a correlation with peripheral vascular elasticity in mild cardiac diastolic dysfunction patients.