高血压患者肱踝动脉脉搏波传导速度与左心室肥厚的相关性

摘要

目的分析高血压患者肱踝动脉脉搏波传导速度(brachial-ankle pulse wave velocity，baPWV)与左心室肥厚的关系。方法入选2009年9月-2012年6月本院969例原发性高血压患者，按照左心室肥厚定义将其分为高血压伴左心室肥厚(n=380)、高血压不伴左心室肥厚(n=589)两组。应用全自动动脉硬化测定仪测定双侧baPWV，取双侧baPWV平均值。结果高血压伴左心室肥厚组baPWV水平明显高于高血压不伴左心室肥厚组(P＜0.05)。线性相关分析表明高血压患者baPWV水平与室间隔厚度(r=0.139，P＜0.01)、左心室后壁厚度(r=0.124，P＜0.01)以及左心室重量指数呈正相关(r=0.312，P＜0.01)。进一步应用多元线性回归分析调整了年龄、性别、体重指数、收缩压、舒张压、血糖、血清胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三酯等心血管危险因素的影响后，baPWV与室间隔厚度(标化的相关系数β=0.125，P＜0.05)、左心室后壁厚度(标化的相关系数β=0.131，P＜0.05)以及左心室重量指数(标化的相关系数β=0.027，P＜0.01)仍然相关。结论高血压患者baPWV与左心室肥厚密切相关。%Objective To analyze the correlation between brachial-ankle pulse wave velocity (baPWV) and left ventricular hypertrophy (LVH) in hypertensive patients. Methods A total 969 primary hypertensive patients admitted to our hospital from September 2009 to June 2012 were divided into hypertension with LVH group (n=380) and hypertension without LVH group (n=589). Their bilateral baPWV was measured with automatic arteriosclerosis detector and its average value was calculated. Results The baPWV value was significantly higher in hypertension with LVH group than in hypertension without LVH group (P < 0.05). Linear correlation analysis showed that the baPW value was positively correlated with the interventricular septal thickness (r=0.139;P <0.01), LV posterior wall thickness (r=0.124, P < 0.01), and LV mass index (r=0.312, P < 0.01). Multivariate linear regression analysis displayed that the baPWV value was correlated with the interventricular septal thickness (β=0.125, P <0.05), LV posterior wall thickness (β=0.131, P < 0.05), and LV mass index (β=0.027, P < 0.01) after adjustment of cardiovascular risk factors, such as age, gender, BMI, SBP, DBP, blood glucose, serum cholesterol, LDL cholesterol, HDL cholesterol, triglyceride. Conclusion baPWV is closely correlated with LVH in hypertensive patients.