陶春燕① 陳萬春② 陳貽訓① 林銀康① 趙德强① 金惠根①
①上海中醫藥大學附屬普陀醫院心內科（上海，200062，中國）
②上海交通大學附屬第六人民醫院心內科（上海，200233，中國）
摘要  目的  探討高血壓左房大小與24小時動態血壓（ABPM）、體重指數（BMI）、左室重量指數（LVMI）以及性別、年齡的相關性。方法  100例高血壓病患者經心超測得左房內徑、左室舒張末期內徑（LVED）、舒張期室間隔厚度、左室後壁厚度，應用Penn公式計算出左室心肌質量指數（LVMI）。左房大小與BMI、LVMI、ABPM的各項參數應用逐步回歸分析法進行統計學處理，性別和年齡應用t檢驗方法分析。結果  高血壓左房大小與BMI相關性非常顯著（P＜0.01），與LVMI、白晝平均收縮壓、夜間收縮壓負荷顯著相關（P＜0.05），與24小時平均脉壓呈負相關，與性別、年齡無顯著相關（P＞0.05）。結論  高血壓左房擴大與BMI、LVMI、白晝平均收縮壓、夜間收縮壓負荷呈正相關，與24小時平均脉壓呈負相關，SBP、DBP升高與左房擴大均有關，高血壓可導致左房擴大，誘發心房顫動、腦卒中，應注意控制血壓和體重。
關鍵詞  高血壓 左房擴大 超聲心動圖 24小時動態血壓
Analysis of factors involved in left atrial dilatation in systemic  hypertention
TAO Chunyan①,CHEN Wanchun②,CHEN Yixun①,LIN Yinkang①,ZHAO Deqiang①,JIN Huigen①.
①Putuo hospital affiliated to Shanghai traditional Chinese medicine university (Shanghai,200062,China)
②Shanghai sixth people’s hospital affiliated to Jiaotong university(Shanghai,200233,China)
Abstract  Objective  To probe the correlation between left atrial dilatation in hypertention and BMI、LVMI、sex、age and the various ABPM reference values.Methods  One hundred hyperteneion patients were enrolled.Left atrial diameter、LVED、IVS、LVPW thickness were determined by ultrasound cardiography.ABPM were undertaken to yield the various reference values.Results  There was no statisticly significant relation between left atrial size and age or sex（P＞0.05）,while BMI was highly significantly related（P＜0.01）, LVMI was significantly related with left atrial size（P＝0.011）.Left atrial size was significantly related to average daytime systolic pressure and nighttime systolic pressure load；pulse pressure was negtively related to left atrail size.Conclusions  Increased systolic pressure contributed to left atrial dilatation and BMI、LVMI as well.Hypertention can lead to left atrial dilatation,followed by atrial fibrillation and even stroke.  Due attention should be paid.
Keywords  Hypertention;Left atrial dilatation;ultrasound cardiography;Ambulatory Blood Pressure Measurement
近年來，非瓣膜心臟病，尤其是高血壓病已日益成爲年長患者房顫（Af）的重要原因之一，而Af的發生和持續與高血壓病所致左房大小有關，然而，過去對高血壓與左房大小之間的關係研究較少，爲此，我們對100例高血壓病患者24小時動態血壓（ABPM）中各項參數、體重指數（BMI）、左室質量指數（LVMI）以及心超測得的左房大小進行檢測，探索其相關性。