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目的探讨高血压患者血清脂联素水平对左心室心肌质量(LVM)及舒张功能的影响。方法入选单纯高血压患者65例(其中男性36例,女性29例;年龄34～78岁,平均年龄53.78岁)和正常对照组33例(其中男性17例,女性16例;年龄32～65岁,平均年龄52岁)。采用酶联免疫吸附分析法测定血清脂联素水平。采用超声心动图测定LVM、左心室射血分数和代表左心室舒张功能的指标E/e比值、舒张早期左心室内血流传播速度(Vp)和左心室Tei指数。结果高血压组左心室心肌质量指数显著高于正常对照组[(123.58±45.40)g/m2 vs(87.29±17.40)g/m2;P<0.05]。高血压组Vp显著低于正常对照组[(41.25±9.86)cm/s vs(56.31±8.79)cm/s,P<0.01],而E/e比值和Tei指数显著高于正常对照组(8.28±1.96 vs 7.26±1.56,0.46±0.15 vs 0.39±0.12;P<0.05)。在高血压组中血清脂联素水平与左心室心肌质量指数、E/e比值和Tei指数均呈显著负相关(r分别为-0.36、-0.56、-0.58,P<0.05),而与Vp呈显著正相关(r为0.67,P=0.023)。多元逐步回归分析表明血清脂联素水平能分别进入以Vp和Tei指数为因变量的回归方程中。结论血清脂联素水平与左心室心肌质量指数呈显著负相关,血清脂联素水平降低是导致左心室舒张功能降低的危险因素之一。
Objective To investigate the effect of serum adiponectin level on left ventricular mass (LVM) and diastolic function in patients with essential hypertension. Methods Totally 65 hypertensive patients (36 males, 29 females, aged 34-78 years, mean age 53.78 years) and 33 normal controls (including 17 males and 16 females, aged 32-65 years , Average age 52 years old). Serum adiponectin levels were measured by enzyme-linked immunosorbent assay. Echocardiography was used to measure left ventricular ejection fraction (LVM), E / e ratio of left ventricular diastolic function, left ventricular diastolic velocity (Vp) and left ventricular Tei index. Results The left ventricular mass index of hypertension group was significantly higher than that of the control group [(123.58 ± 45.40) g / m2 vs (87.29 ± 17.40) g / m2; P <0.05]. The Vp in hypertensive group was significantly lower than that in the control group [(41.25 ± 9.86) cm / s vs (56.31 ± 8.79) cm / s, P <0.01] ± 1.96 vs 7.26 ± 1.56,0.46 ± 0.15 vs 0.39 ± 0.12; P <0.05). Serum adiponectin levels in hypertension group were negatively correlated with left ventricular myocardial mass index, E / e ratio and Tei index (r = -0.36, -0.56, -0.58, P <0.05, respectively) There was a significant positive correlation (r = 0.67, P = 0.023). Multiple stepwise regression analysis showed that serum adiponectin levels could enter the regression equation with Vp and Tei index as dependent variables respectively. Conclusions The level of serum adiponectin is negatively correlated with the myocardial mass index of left ventricle. The decrease of serum adiponectin level is one of the risk factors of decreasing left ventricular diastolic function.