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· 臨床研究·
基金項目:衛(wèi)生部資助項目(WKZ 2200021203)
作者單位:250012 濟南,山東大學齊魯醫(yī)院心內(nèi)科
高血壓病左心室質(zhì)量和舒張功能改變
與內(nèi)分泌因子的關(guān)系
張梅 方永奇 張運 蔡恒 郭媛 安豐雙 卜培莉 葛志明 黎莉
【摘要】 目的 應用二維及組織多普勒超聲( TDI)技術(shù)探討高血壓病患者左心室質(zhì)量和舒張功能與內(nèi)分泌
因子的關(guān)系。方法 61 例高血壓病患者根據(jù)超聲心動圖測量左室質(zhì)量指數(shù) (LVMI) 分為左室心肌肥厚組
(LVH ,30例)和非左室心肌肥厚組(NLVH ,31例) 。20 例健康者為對照組。組織多普勒測量二尖瓣環(huán)心肌舒張
早期峰值運動速度(e) 、晚期峰值運動速度(a)及其比值(e/ a) 。放射免疫法分析血漿心鈉素(ANP) 、腦鈉素
(BNP) 、內(nèi)皮素( ET) 、降鈣素基因相關(guān)肽(CGRP)及血清胰島素樣類生長因子21 ( IGF21)的濃度。結(jié)果 高血壓
病LVH組與 NLVH組及對照組比較 ,e 波峰值速度降低 , [分別為(14. 56 ±7. 83) cm/ s、 (16. 40 ±0. 66) cm/ s、(18. 68±3. 78) cm/ s ] ,a 波峰值速度增高 , [分別為(18. 28 ±9. 60) cm/ s、 (16. 03 ±5. 88) cm/ s、 (14. 53 ±1. 28)
cm/ s ] ;LVH和 NLVH組的 e波及 a波峰值速度與對照組比較 ,差異有顯著性意義( P < 0. 05) ;對照組、高血壓
病 NLVH組、 LVH組二尖瓣側(cè)環(huán)e/ a值依次顯著減小(1. 42±0. 11 ,0. 88 ±0. 12 ,0. 74 ±0. 09 , P < 0. 001) 。對照
組、高血壓病NLVH組、 LVH組血漿 ET、 ANP、 BNP及血清 IGF21 濃度依次顯著升高( P < 0. 001) ;對照組、高血
壓病 NLVH組、 LVH組血漿 CGRP濃度依次顯著降低( P < 0. 001) 。ET與 e/ a 顯著負相關(guān)( r = - 0. 79 , P <
0. 01) ;ANP、 BNP、 IGF21 與 e/ a中度負相關(guān)( r分別為 - 0. 62、 - 0. 56、 - 0. 61 , P < 0. 01) ;CGRP與 e/ a 中度正
相關(guān)( r = 0. 60 , P < 0. 01) 。結(jié)論 高血壓病左室結(jié)構(gòu)和舒張功能異常與 5 種內(nèi)分泌因子改變均有較好的相關(guān)
性 ,表明內(nèi)分泌因子在高血壓病左室質(zhì)量和舒張功能的異常改變中具有重要作用。
【關(guān)鍵詞】 超聲心動描記術(shù);高血壓;心室功能 ,左;肽類
Relations between left ventricular ma ss ,dia stolic function and endocrine factors in e ssential h ypertension ZHA N G
Mei , FA N G Yong2qi , ZHA N G Yun , et al . Department of Cardiology , Qilu Hospital of S handong University , Jinan
250012 , China
【Abstract】 Objective To study the changes of diastolic function of left vent ricle by tissue Doppler imaging
( TDI) and the serum level of endocrine factors ,and analyse the relations between these factors and mass or diastolic
function of left vent ricle in patients with essential hypertension. Methods Sixty2 one patients with essential
hypertension were divided into left vent ricular hypert rophy (LVH) group and no left vent ricular hypert rophy (NLVH)
group . Twenty healthy subjects were considered as cont rol group. The early(e) and late (a) diastolic maximal myocardial
velocity and e/ a of lateral wall motion of mit ral valve annulus were recorded b y TDI. The levels of at rial nat ritic peptide
(ANP) , brain nat riuretic peptide (BNP) , endothelium ( ET) , calcitonic gene2related peptide (CGRP) and insulin2like
growth factor21 ( IGF21) were measured by radio2immunology analysis. Re sults The e wave maximal velocity in LVH
group was lower than that of NLVH group and cont rol group [ (14. 56±7. 83) cm/ s , (16. 40 ±0. 66) cm/ s , (18. 68±
3. 78) cm/ s ,respectively ] , and a wave maximal velocity in LVH group was higher than that of NLVH group and
cont rol group [ ( 18. 28 ±9. 60) cm/ s , ( 16. 03 ±5. 88) cm/ s , ( 14. 53 ±1. 28) cm/ s , respectively ] ; The e and a
maximal velocity velocities in both LVH and NLVH groups had statistic differences with those of cont rol group ( P <
0. 05) . The e/ a of wall motion of mit ral valve annulus decreased gradually in cont rol group ,NLVH group and LVH
group (1. 42 ±0. 11 ,0. 88 ±0. 12 ,0. 74 ±0. 09 , P < 0. 001) . ET ,ANP ,BNP and IGF 21 all increased in NLVH group
( P < 0. 001) and increased further in LVH group , while CGRP decreased in NLVH group ( P < 0. 001) and
decreased further in LVH group. There were moderate correlations between the endocrine factors with e/ a( r = 0. 60 ,P < 0. 01) . Conclusions The decreased diastolic function of left vent ricle assessed b y TDI correlates with changes of
the endocrine factors in the patients with hypertension.
【Key words】 Echocardiography ; Hypertension ;Vent ricle function ,left ; Pe ptides
· 588 · 中華超聲影像學雜志2004 年12 月第13 卷第12 期 Chin J Ult rasonogr ,December 2004 ,Vol 13 ,No. 12
? 1995-2005 Tsinghua Tongfang Optical Disc Co., Ltd. All rights reserved. 許多研究證明高血壓病患者在左心室收縮功能和
心臟結(jié)構(gòu)正常時就可出現(xiàn)左心室舒張功能的異
常[1 ,2 ] ......
基金項目:衛(wèi)生部資助項目(WKZ 2200021203)
作者單位:250012 濟南,山東大學齊魯醫(yī)院心內(nèi)科
高血壓病左心室質(zhì)量和舒張功能改變
與內(nèi)分泌因子的關(guān)系
張梅 方永奇 張運 蔡恒 郭媛 安豐雙 卜培莉 葛志明 黎莉
【摘要】 目的 應用二維及組織多普勒超聲( TDI)技術(shù)探討高血壓病患者左心室質(zhì)量和舒張功能與內(nèi)分泌
因子的關(guān)系。方法 61 例高血壓病患者根據(jù)超聲心動圖測量左室質(zhì)量指數(shù) (LVMI) 分為左室心肌肥厚組
(LVH ,30例)和非左室心肌肥厚組(NLVH ,31例) 。20 例健康者為對照組。組織多普勒測量二尖瓣環(huán)心肌舒張
早期峰值運動速度(e) 、晚期峰值運動速度(a)及其比值(e/ a) 。放射免疫法分析血漿心鈉素(ANP) 、腦鈉素
(BNP) 、內(nèi)皮素( ET) 、降鈣素基因相關(guān)肽(CGRP)及血清胰島素樣類生長因子21 ( IGF21)的濃度。結(jié)果 高血壓
病LVH組與 NLVH組及對照組比較 ,e 波峰值速度降低 , [分別為(14. 56 ±7. 83) cm/ s、 (16. 40 ±0. 66) cm/ s、(18. 68±3. 78) cm/ s ] ,a 波峰值速度增高 , [分別為(18. 28 ±9. 60) cm/ s、 (16. 03 ±5. 88) cm/ s、 (14. 53 ±1. 28)
cm/ s ] ;LVH和 NLVH組的 e波及 a波峰值速度與對照組比較 ,差異有顯著性意義( P < 0. 05) ;對照組、高血壓
病 NLVH組、 LVH組二尖瓣側(cè)環(huán)e/ a值依次顯著減小(1. 42±0. 11 ,0. 88 ±0. 12 ,0. 74 ±0. 09 , P < 0. 001) 。對照
組、高血壓病NLVH組、 LVH組血漿 ET、 ANP、 BNP及血清 IGF21 濃度依次顯著升高( P < 0. 001) ;對照組、高血
壓病 NLVH組、 LVH組血漿 CGRP濃度依次顯著降低( P < 0. 001) 。ET與 e/ a 顯著負相關(guān)( r = - 0. 79 , P <
0. 01) ;ANP、 BNP、 IGF21 與 e/ a中度負相關(guān)( r分別為 - 0. 62、 - 0. 56、 - 0. 61 , P < 0. 01) ;CGRP與 e/ a 中度正
相關(guān)( r = 0. 60 , P < 0. 01) 。結(jié)論 高血壓病左室結(jié)構(gòu)和舒張功能異常與 5 種內(nèi)分泌因子改變均有較好的相關(guān)
性 ,表明內(nèi)分泌因子在高血壓病左室質(zhì)量和舒張功能的異常改變中具有重要作用。
【關(guān)鍵詞】 超聲心動描記術(shù);高血壓;心室功能 ,左;肽類
Relations between left ventricular ma ss ,dia stolic function and endocrine factors in e ssential h ypertension ZHA N G
Mei , FA N G Yong2qi , ZHA N G Yun , et al . Department of Cardiology , Qilu Hospital of S handong University , Jinan
250012 , China
【Abstract】 Objective To study the changes of diastolic function of left vent ricle by tissue Doppler imaging
( TDI) and the serum level of endocrine factors ,and analyse the relations between these factors and mass or diastolic
function of left vent ricle in patients with essential hypertension. Methods Sixty2 one patients with essential
hypertension were divided into left vent ricular hypert rophy (LVH) group and no left vent ricular hypert rophy (NLVH)
group . Twenty healthy subjects were considered as cont rol group. The early(e) and late (a) diastolic maximal myocardial
velocity and e/ a of lateral wall motion of mit ral valve annulus were recorded b y TDI. The levels of at rial nat ritic peptide
(ANP) , brain nat riuretic peptide (BNP) , endothelium ( ET) , calcitonic gene2related peptide (CGRP) and insulin2like
growth factor21 ( IGF21) were measured by radio2immunology analysis. Re sults The e wave maximal velocity in LVH
group was lower than that of NLVH group and cont rol group [ (14. 56±7. 83) cm/ s , (16. 40 ±0. 66) cm/ s , (18. 68±
3. 78) cm/ s ,respectively ] , and a wave maximal velocity in LVH group was higher than that of NLVH group and
cont rol group [ ( 18. 28 ±9. 60) cm/ s , ( 16. 03 ±5. 88) cm/ s , ( 14. 53 ±1. 28) cm/ s , respectively ] ; The e and a
maximal velocity velocities in both LVH and NLVH groups had statistic differences with those of cont rol group ( P <
0. 05) . The e/ a of wall motion of mit ral valve annulus decreased gradually in cont rol group ,NLVH group and LVH
group (1. 42 ±0. 11 ,0. 88 ±0. 12 ,0. 74 ±0. 09 , P < 0. 001) . ET ,ANP ,BNP and IGF 21 all increased in NLVH group
( P < 0. 001) and increased further in LVH group , while CGRP decreased in NLVH group ( P < 0. 001) and
decreased further in LVH group. There were moderate correlations between the endocrine factors with e/ a( r = 0. 60 ,P < 0. 01) . Conclusions The decreased diastolic function of left vent ricle assessed b y TDI correlates with changes of
the endocrine factors in the patients with hypertension.
【Key words】 Echocardiography ; Hypertension ;Vent ricle function ,left ; Pe ptides
· 588 · 中華超聲影像學雜志2004 年12 月第13 卷第12 期 Chin J Ult rasonogr ,December 2004 ,Vol 13 ,No. 12
? 1995-2005 Tsinghua Tongfang Optical Disc Co., Ltd. All rights reserved. 許多研究證明高血壓病患者在左心室收縮功能和
心臟結(jié)構(gòu)正常時就可出現(xiàn)左心室舒張功能的異
常[1 ,2 ] ......
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