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背景:临床观察发现高血压及冠心病患者普遍存在左心房扩大,但左房扩大的发生机制及临床意义尚未完全明了。目的:探讨高血压及冠心病患者左心房内径的变化的临床意义及其与心功能的相关性。设计:以诊断为依据的病例对照研究。地点、对象和方法:选择在成都军区昆明总医院就诊的360例高血压患者、286例冠心病患者及255例健康人为研究对象。应用彩色多普勒超声心动图仪、三导心电图仪及24h动态心电图仪,测定左房内径、左室舒张末内径(leftventriculardiastolicdiameter,LVDd)、左室后壁厚度(leftventricularposteriorwallthickness,LVPWT)、室间隔厚度(septalthink-ness,IVST)、每搏输出量(strokevolume,SV)、每分输出量、射血分数值、E/A比值。以观察左房扩大及左室肥厚与心功能的相关性。主要观察指标:各组患者左房内径的变化,左房内径与左心室肥大及心功能的关系。结果:高血压组及冠心病组左房内径分别为(30.13±5.54),(31.35±5.84)mm较正常对照组犤(26.82±6.11)mm犦显著增加。高血压组及冠心病组伴LAD扩大者射血分数犤(49.12±12.11)%犦及E/A(0.86±0.2)显著降低。结论:高血压组及冠心病患者左房内径较正常者增加,1/3以上高血压组及冠心病组患者伴有左房扩大。左房内径扩大与左心室肥大及心功能减退有
BACKGROUND: Clinical observations have found that left atrial enlargement is common in patients with hypertension and coronary heart disease. However, the mechanism and clinical significance of atrial enlargement have not been fully understood. Objective: To investigate the clinical significance of left atrial diameter changes in patients with hypertension and coronary heart disease and its correlation with cardiac function. Design: A case-control study based on diagnosis. Location, Subjects and Methods: A total of 360 hypertensive patients, 286 CHD patients and 255 healthy subjects attending the Kunming General Hospital of Chengdu Military Region were selected as the study subjects. Left ventricular diameter, left ventricular end diastolic diameter (LVDd), left ventricular posterior wall thickness (LVPWT), interventricular septum thickness (LVPWT) were measured by color Doppler echocardiography, three-lead electrocardiograph and 24h electrocardiograph. septalthink-ness (IVST), strokevolume (SV), output per minute, ejection fraction, E / A ratio. To observe the expansion of left atrium and left ventricular hypertrophy and cardiac function. MAIN OUTCOME MEASURES: Changes in left atrial diameter, left atrial diameter and left ventricular hypertrophy and cardiac function in each group. Results: The left atrial diameter of hypertensive group and coronary heart disease group were (30.13 ± 5.54) mm and (31.35 ± 5.84) mm, respectively, which were significantly higher than those of the control group (26.82 ± 6.11 mm). The ejection fraction (49.12 ± 12.11)% 犦 and E / A (0.86 ± 0.2) in patients with hypertension and coronary heart disease with LAD enlargement were significantly decreased. Conclusion: The left atrium diameter of patients with hypertension and coronary heart disease is higher than that of normal subjects. One third or more hypertensive patients and coronary heart disease patients are accompanied by left atrial enlargement. Left atrial diameter enlargement and left ventricular hypertrophy and cardiac dysfunction are